Southwest border cities burdened with medical calls
Calls for medical assistance at the border have become a growing burden on the finances and resources of fire departments from San Diego to Brownsville, Texas.
The New York Times
CALEXICO, Calif. — The calls come in thick and fast from the border, just blocks from the fire station here.
A woman suffered heat stroke in line at the port of entry. A person detained by customs officers complained of chest pain. An illegal immigrant broke his leg trying to hop the 20-foot wall that divides Calexico from its Mexican twin city, Mexicali.
In each case, the Calexico Fire Department responded.
All along the Southwest border, from San Diego to Brownsville, Texas, local fire departments respond to medical calls as they would to any emergencies within their city limits.
But such calls for medical assistance at the border have become a growing burden on the finances and resources of fire departments in cities like this one, in the California desert 100 miles east of San Diego.
Last year, with trips to the port of entry and the Border Patrol station and others to assist injured fence-jumpers, Calexico firefighters responded to 725 calls associated with the border — a fifth of all calls the department received.
Chief Pete Mercado said the department's lone ambulance would sometimes make 10 trips to the port of entry in a given day. For many of those, he said, the department is not able to collect payment, while the ambulance is rendered unavailable for other emergencies.
"It's a very difficult thing for us to continue to do without some type of funding," Mercado said. "We've absorbed the cost for all these years. I can't express how difficult it is."
Rep. Bob Filner, a Democrat who represents California's entire border with Mexico, introduced a bill last year that would have required the federal government to reimburse cities for the cost of providing emergency-response services at the border. But with Congress struggling to reduce the $1 trillion federal deficit, the bill seems unlikely to pass.
"At a time when every city budget is affected, the federal government should not be relying on local revenue to deal with these issues," Filner said. "Unfortunately, there is very little understanding of the border situation in Congress."
Calexico is hardly the only city fire department strained by constant runs to the border.
In San Diego, the Fire Department responded to more than 2,000 medical emergencies at border crossings last year. In San Luis, Ariz., at least 70 percent of the calls that the Fire Department receives come from the port of entry, officials said.
A huge portion of the patients at the ports of entry or in Border Patrol custody have no health insurance, according to the fire departments, leaving the departments to cover the cost of care.
In El Paso through the first six months of this year, the Fire Department collected reimbursement on 18 percent of the cost of calls to the port of entry, compared with a collection rate of more than 50 percent for all calls.
In Douglas, Ariz., the fire chief, Mario Novoa, estimated that about 15 percent of the department's calls came from the port of entry. Firefighters also offer medical assistance to people the Border Patrol finds in the desert, more than 25 miles outside the city limits.
Novoa called the collection rate on trips associated with the border "dismal" and "a burden on the taxpayers."
Already, the federal government does cover some of the costs that local fire departments incur in responding to calls from the border. Some departments received federal grants — in San Luis, the grants account for most of the Fire Department's operating budget, while in Calexico and Douglas, grants make up less than 10 percent of the budgets, according to fire officials.
In addition, the federal government is responsible for the cost of medical care when a person has been taken into custody by customs officers or Border Patrol agents.
In practice, however, fire chiefs in several border cities said they were seldom able to collect any reimbursement from the U.S. Customs and Border Protection service in such cases.
"Sometimes the calls do originate from the Border Patrol, when the patient is in custody, and the bill does get sent to the federal government," Novoa said. "The fact of the matter is, though, we don't recoup anything. You'd think it would be a no-brainer."
Officials from Customs and Border Protection declined to provide statistics about reimbursement for medical treatment of people in custody.
In Calexico, each call usually ties up the city's lone ambulance for at least an hour, as firefighters drive to the nearest hospital, in neighboring El Centro, and back.
Sylvia Bernal said she worries that the delay might have been fatal for her mother. Eight years ago, Bernal, now 62, called 911 when her mother began complaining of back pain. The Calexico Fire Department sent a fire truck and paramedics, but they waited 20 minutes for the ambulance, which was on another call, to arrive.
By the time the ambulance reached the hospital, her mother's lung had collapsed. She died hours later.
"I don't know what would have happened if the ambulance would have gotten there in time," Bernal said. "To have to live with this 'what if' for a long time, I don't wish that on anyone."