Quick Hit Ellyn Fortino Monday August 12th, 2013, 12:01pm

Activists Demand Justice For Uninsured Immigrants In Need Of Organ Transplants

Immigrants in need of organ transplants and their allies have occupied the public space in front of Chicago’s Northwestern Memorial Hospital. The occupation began Sunday evening following the Friday death of Sarai Rodriguez, 25, an uninsured and undocumented Chicago immigrant originally from Mexico who was in critical need of a new liver.

Rodriguez’s family and dozens of activists held a remembrance ceremony outside Northwestern Sunday evening and camped out overnight. The occupation will continue through Monday, the group said.

Community activists say Rodriguez and 13 other undocumented immigrants have been denied spots on transplant waiting lists at Chicago-area hospitals because they are uninsured and undocumented.

Twenty people, including some of the immigrants who were denied kidney and liver transplants, went on a 10-day hunger strike that began July 29 demanding administrators at Advocate Christ Medical Center, Northwestern and the University of Illinois at Chicago Medical Center have meetings with them.

The hunger strike ended August 8 after representatives from the hospitals met with the group last week and said negotiations and communication with the immigrant patients would continue, the activists said.

Victoria Rodriguez, Sarai’s mother, said her daughter was denied a liver transplant back in March by Northwestern Memorial Hospital because she was uninsured and could not pay for the procedure. Sarai needed half of her liver transplanted, which was projected to cost between $200,000 and $500,000, Victoria said. That figure did not include the costs of medicine and the follow-up care that would be needed after the procedure.

Victoria had more recently asked Northwestern, which has an esteemed transplantation center, for an appointment to discuss Sarai’s case further, she said. The hospital agreed to a September 5 appointment, but it did not come soon enough for Sarai.

“I am very sad, because we didn’t have the support that we wanted,” Victoria said outside Northwestern. “We need to come [together] and fight to change the system in these hospitals.”

Northwestern is accountable for Sarai’s death, said Jose Landaverde, an organizer of the hunger strike and pastor at Our Lady Guadalupe Anglican Catholic Mission in Little Village. The activists are urging the hospital’s administrators to resolve this “discriminatory” transplantation policy before more uninsured immigrants in need of new organs die.

"We know the hospitals have started negotiations, but so far all we have is vague promises, nothing in writing, no guarantees, no policy changes," Landaverde said. "Meanwhile, our people are dying. Hospital administrators and politicians bury us in false promises and bureaucracy, and they expect us to die quietly.”

Representatives from Advocate Christ Medical Center and Northwestern told the group last week that a patient’s documentation status would not prevent them from being placed on the transplant list. The hospitals maintain that citizenship has not been a factor in determining whether a patient qualifies for a transplant.

Though a patient’s immigration status may not bar them from being placed on the list, according to the hospitals, that doesn’t guarantee that the undocumented can actually receive transplants, however. That’s because the patients have to show that they can pay for the costly medication and follow-up care needed after the procedure. According to the activists, post-operation costs for an organ transplant patient are $20,000 to $30,000 each year.

The group says the immigrant patients cannot afford the care because they lack health insurance and do not qualify for federal health benefits like Medicare and Medicaid because they are not U.S. citizens. Undocumented immigrants in need of health insurance are also excluded from coverage under the Affordable Care Act.

“The fact that transplantations [are] not only are expensive, but require life-long expensive medications keep people who are uninsured from actually accessing transplantation easily,” said Rush University Medical Center’s Chief Medical Officer David Ansell, an advocate for the immigrant patients.

Ansell has scheduled an August 27 roundtable discussion with transplantation centers, community leaders and politicians to address the issue. 

Blanca Gomez, 23, is one of the immigrants in need of a new kidney who participated in the hunger strike. According to Gomez, Northwestern told her she was not qualified to be on its transplant waitlist when she went into kidney failure in 2012.

Gomez said she tried to set up another evaluation at Northwestern on Friday, but was told, again, that she does not qualify for a transplant because she doesn’t have a Social Security number and insurance, she said. A kidney transplant would cost about $500,000 and $30,000 each month for the necessary medication, she said.

“Northwestern give us care, because were dying,” Gomez pleaded outside of the hospital on Sunday. “Sarai just passed away two days ago, because she didn’t have the care. Please Northwestern. Listen to us. We need help.”

Northwestern did not comment for this story, but did provide Progress Illinois with the statement it released last Monday in response to the hunger strike:

The primary focus of Northwestern Memorial Hospital’s transplant program is to save lives and restore health where possible. All prospective candidates are evaluated against a rigorous set of standards; U.S. citizenship is not among them. The criteria for recipient selection are the same for every candidate regardless of citizenship or other immigration status.

Our multidisciplinary teams of clinicians and social workers review a host of determining factors that might forecast an individual’s chances for a successful surgery as well as their means for long-term stability with a transplanted organ. Such present health indications and potential contraindications are imperative to qualifying people for an organ wait list. Criteria include such things as medical and psychosocial factors like home life and social environment, and the ability to meet the demands of a lifetime of routine doctor visits and costly anti-rejection medications.

Our processes follow policies compliant with federal regulations, and patients are either endorsed for or denied organ recipient status according to factors that are known to be associated with good long-term outcomes. We believe such careful and meticulous standards ensure fair and equitable evaluation of everyone seeking transplant and allow us to ensure the greatest opportunities for viability of patients with donated organs.

Ansell called the lack of access that uninsured people have to transplantations a “moral and an ethical issue.”

“It’s not right for someone not to be able to get life saving treatment just because they don’t have insurance. And unfortunately for people who are here and not citizens, they might not even have access to the insurance funds that are needed to prolong lives,” he said.

Although this issue has been brought to light in Chicago, it’s also a national problem, Ansell stressed.

Out of all the organs donated in the country, 20 percent of them come from people who are uninsured, yet only 1 percent of uninsured people get transplants, he said.

“That’s a tragedy, but people who are uninsured can’t get medications, and if you can’t get medications, you have a risk of rejecting the organ,” Ansell said. “If you reject the organ, that’s obviously not a good thing to do.”

Ansell also noted that overall there are far more people who need transplants in the country than the number of available organs to transplant. The community activists, however, say it’s “discriminatory” that hospitals can accept organs from the undocumented but refuse to give them transplants because they cannot pay.

At a Friday press conference in Little Village when it was announced that Sarai was being taken off life support, State Rep. Edward Acevedo (D-Chicago) announced plans to introduce a resolution in Springfield this week that would call for a new “Blue Ribbon” state panel of hospital administrators. Acevedo wants Ansell to lead the panel, which would work to secure private and government funds to help the uninsured in Illinois pay for transplant-related costs.

Acevedo said he hopes to bring the resolution up for a vote during the fall veto session. If the resolution were to pass, it would take effect immediately.

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