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'I Don't Know What I Could Do for My Mother Now'

Welfare: Illegal immigrants face eviction from nursing homes.


Marta Jimenez prefers to think of her mother in better times--as an airy, cheerful presence caring for her grandchildren, happily doing the household chores, tending the flowers outside the family apartment. Not the ghostly, disoriented figure who today shuffles through an El Monte nursing home in her stocking feet, sometimes failing to recognize her eldest daughter.

"It hurts me deeply to see my mother as she is now and I pray to God that he will take her," a tearful Jimenez said in the lobby of the sterile facility that her mother, an Alzheimer's patient, calls home.

Now, Jimenez, having finally made the difficult decision to institutionalize her 75-year-old mother this summer, is bracing for the shock of having her mother evicted.

Her mother, Francisca Echeverria, is among the hundreds, perhaps thousands, of elderly and disabled illegal immigrants nationwide who face a loss of federal benefits under the sweeping overhaul of the nation's welfare system signed by President Clinton last month. The new law makes them ineligible for long-term care benefits under Medicaid, the public insurance plan for the poor. Without Medicaid, known as Medi-Cal in California, most will face ouster.


The uncertain fates of these nursing home patients are among the most poignant tales to emerge in the wake of approval of the law, whose ramifications are still not fully understood. During congressional debate, little discussion focused on the prospect of elderly and disabled patients being thrown out of nursing homes.

Ironically, the potential crisis has created a rare arena of agreement between Gov. Pete Wilson and immigrant advocates. Both sides say something should be done to care for this population.

Jimenez, who supports two school-age children on a meager salary earned cleaning houses and offices, cannot afford the $3,000-a-month nursing home price tag. It is a challenge just meeting her family's basic bills, including the monthly rent of $600.

"I don't know what I could do for my mother now," said Jimenez, adding that she would probably have to quit work and become, in effect, a 24-hour nurse, enlisting the support of her children to help. "I guess I would have to lock her in a room for her own safety."

The long-term care population affected by the new law is in need of skilled nursing supervision on a 24-hour basis, though their conditions may vary greatly. Most are elderly, but some are younger victims of debilitating illnesses or accidents. Some have families capable of assisting with their care; others have no responsible relatives, here or in their homelands. Some may end up on the streets and in emergency rooms--at much greater public cost, argue activists working on behalf of nursing home patients.

"Potentially, this could become a catastrophe," said Pat McGinnes, head of the California Advocates for Nursing Home Reform.

Wilson, widely assailed in some quarters for his high-profile targeting of illegal immigrants, has vowed to seek alternative funding sources to maintain care of this vulnerable population. The governor made this exception even as he issued a sweeping executive order in response to the new welfare law, directing state agencies to begin the process of cutting off illegal immigrants from myriad state-funded programs, from breast cancer detection to post-secondary education to the issuance of licenses and contracts.

"We're looking at other options to try and make sure these people do receive the care they need," said Burt Cohen, assistant secretary of the California Health and Welfare Agency.

But no one knows where the money will come from, underscoring the lack of easy solutions to this dilemma. Advocates are hopeful that many undocumented residents receiving long-term care could be categorized as "emergency" cases--the only federal Medicaid category now open to illegal immigrants. Whether that approach will fly is uncertain.

For its part, the multibillion-dollar nursing home industry is also alarmed about the prospects of mass evictions, a loss of Medicaid revenue--or being stuck with nonpaying clients.

Looming over the entire issue is the likelihood of protracted litigation. Civil libertarians have vowed to be in court swiftly in an effort to block any benefit cutoffs.

The new welfare law's extensive targeting of immigrants, both illegal and lawful, is illustrative of how, since the emergence of Proposition 187, lawmakers keen to reduce immigration have increasingly focused on benefits.

"The fact is, there's not enough money in this country, period, to provide for all the needs of the rest of the world," said U.S. Rep. Elton Gallegly (R-Simi Valley), who heads the Congressional Task Force on Immigration and has spearheaded congressional efforts to deny public education to illegal immigrant youngsters.

But even Gallegly acknowledges that government has a "humanitarian" responsibility in the case of those too infirm to survive on their own and lacking family members who can provide for them.

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