Teresa was on a Tucson buying trip in July when her daughter went into early labor. The baby was born, prematurely, at University Medical Center.
That proved to be an unfortunate twist of fate, since UMC has an apparently unique, 5-year-old policy of reporting foreign nationals with unpaid debts to the U.S. Department of Homeland Security. In turn, a collection agency hired by UMC reportedly exploits this policy to get heavy with creditors.
But first, back to our story. Soon after Teresa's grandbaby was born, Tucson attorney Margo Cowan got a phone call from a local neighborhood center "where this little girl has reported that, if they don't pay 'x' by 5 o'clock, this guy's going to report them to immigration, even though their status is completely legal," Cowan says.
"Here's a woman, she and her daughter, coming up to buy things and then going back to sell them in Mexico. They have visas, and they've been doing this forever and ever. The daughter didn't plan on delivering the baby. It just happened while they were here on a business trip.
"So afterward, Mom goes into UMC's business office, and is told to go see a character by the name of Sergio Hernandez," Cowan says. "He's a financial consultant."
Attempts to contact Teresa in Sonora were unsuccessful. But it turns out that Sergio Hernandez is easier to reach. He's a bill collector with International Collection Systems, the company under contract with UMC. According to Cowan, her client's encounter with Hernandez was hardly pleasant. "He says to her something like, 'OK, you have to pay $3,000 now, or I'm going to call up immigration, and they're going to revoke your visa.'"
On her next visit to the collection agency, Teresa brought Cowan along. "Hernandez backed way down when she showed up with a lawyer," Cowan says. "I said to him, 'What's going on here? Here's this lady. She's a businesswoman. All she wants to do is set up her payment plan, and she's sent to you, the strong-arm guys. What are you doing threatening her?'"
When the Tucson Weekly contacted International Collection Systems, an agitated Hernandez hung up on us several times. But in between disconnects, he denied threatening Cowan's client with deportation. "I have never threatened her, or anybody ... with immigration or otherwise," he says.
Then we spoke to his boss, a collections manager who gave his name as Chris Olea. According to Olea, the agency never threatens debtors with their immigration status. "That's not our policy, and this is the first time somebody comes up with that," he says. "You might want to contact the hospital to see if they have any policies like that."
So we did, finally reaching Kevin Burns, UMC's chief financial officer. Burns says the hospital doesn't just automatically dispatch Mexican nationals to a collection agency. "We try to work with them, because, frankly, that saves us time and energy. But it is possible that my staff told them to contact ICS."
When asked whether it would be appropriate to contact federal immigration authorities over such debts, Burns says, "No. Our approach is that we do not threaten people with things like that. We are not a law-enforcement authority. Nor would I accept my staff taking steps like that."
However, a couple of days later, Burns called back with rather different information. "If someone leaves the hospital, and they do not cooperate, they don't respond to us, they don't answer questions--if they don't work with us in helping pay their bill--about seven to 14 days after they leave, we will send a note to ICE (U.S. Immigration and Customs Enforcement)," he says. That note will announce "that someone left without cooperating with us, and they have an unpaid bill. And we've done that for years."
Margo Cowan thinks it's wrong that a quasi-public hospital would be targeting Mexican nationals in such a manner. "How is that different from people in Tucson who walk in the door and have no insurance?" she asks. "Why are they treated differently?"
According to Burns, this unusual collection practice grew from an informal compromise with federal immigration officials, who often refuse to take custody of--and thus foot the bill for--illegal immigrants requiring medical care. "I can tell you that it's resulted in very little recovery over the years," he says. "But the idea is that if ICE has someone in their system, when that person comes back into the states, they will show up as having an unpaid obligation in the United States. And at that time, they will be asked to arrange to solve that obligation."
It sounds good on paper. But in fact, all of these UMC notices of foreign debt--some 300 over four years--have been gathering dust at U.S. Citizenship and Immigration Services, a sister agency to ICE within the Department of Homeland Security.
Marie Sebrechts is a spokeswoman for Citizenship and Immigration Services. Despite all those notifications from UMC, she says, "there is no program within USCIS for receiving information from hospitals."
Nor is there a process for applying that information once it's received. "We have no ability to make people pay medical bills," Sebrechts says. "That's not part of our mission."
Such debts might only matter when someone applies for a visa, she says. "But that's all done on a case-by-case determination. In general, an unpaid hospital bill is not a line item that would keep someone from receiving a benefit."
Meanwhile, those notices from UMC keep coming; Sebrechts says the latest arrived in mid-August. And while she's unaware of other hospitals regularly turning debtors over to the feds, that doesn't make UMC special. "Basically, they're like any other group who wants to submit information to the government. From there, we determine where it's relevant and what to do with it."
But to date, it looks like UMC bills haven't kept anyone stuck at the border. "I've talked to everybody in our district and our field offices," she says, "and we don't have any information on it having affected anybody's ability to come into the country."