The scene at Pindar Vineyards Friday was a little out of the ordinary. Instead of out-of-towners sampling chardonnay and pinot grigio, a health care organization was offering a free clinic in the Peconic tasting room, where bilingual employees took health histories, tested blood pressure, gave nutritional consultations, handed out specialty referrals and scheduled follow-up appointments for about 40 local agricultural workers and their family members.
The event marked the second “Day of Health” organized by Hudson River Healthcare. The first, which occurred in November at Pindar, attracted approximately 70 people, who were also offered free flu shots. The goal of the free clinics, HRHCare CEO Anne Nolon said, is to provide the preventive care to which many such workers — especially those who are in the country illegally — don’t have access. This makes it difficult for them to get routine screening and checkups and, when they do become ill, forces them into emergency rooms with major, and often costly, health problems.
In an area where undocumented immigrants make up about 40 percent of the Hispanic population — something that plays a significant role in the local economy, especially the agricultural industry — finding proper health care when illness strikes can be difficult, said Sister Margaret Smyth, founder of the North Fork Spanish Apostolate.
Her 20-year-old organization, which is funded by the Diocese of Rockville Centre, partners with HRHCare to offer its patrons essential health services and, should they incur large medical bills due to a hospital visit, works closely with them to establish payment plans.
As with any demographic, a certain percentage of undocumented immigrants end up not paying their bills after an ER visit, said Eastern Long Island Hospital CEO Paul Connor, stressing that the hospital doesn’t break down non-payment by legal or citizenship status. In fact, he said, most of ELIH’s “bad debt” — debt that goes unpaid and ends up being covered by donations and fundraisers — derives from behavioral health programs such as addiction treatment and psychiatry, not from the ER.
Thus, Mr. Connor said, any specific financial impact undocumented immigrants have on the hospital would be anecdotal.
“These are local folks who work out here on the East End,” he said. “They want to pay their debt and they want to be part of the local community one way or the other.”
Joe Gergela, former executive director of the Long Island Farm Bureau, estimated in 2013 that there were about 5,000 agricultural workers on the East End and that 60 percent of them — some 3,000 people — were undocumented immigrants from other countries.
Some argue that even if undocumented immigrants do pay for specific emergency room care, they still don’t have to pay for health insurance as citizens are required to do under the Affordable Care Act — and that, they say, makes the playing field uneven. Farmers, for example, note that they are not legally allowed to verify the immigration status of their employees, which makes it impossible to know if they have — and pay for — their own health insurance.
“I want these people to be legal so everybody pays their fair share,” said Jeff Rottkamp, owner of Fox Hollow Farms in Calverton. “They’re a vital part of the local economy. We need them here. They’re good people for the most part, but something’s got to change [with the health care system].”
While the topic of illegal immigration remains controversial in this presidential election year, keeping those who are already here healthy, productive and out of emergency rooms remains central to HRHCare’s mission.
HRHCare has 26 locations stretching from Long Island to the Hudson Valley and operates all eight of Suffolk County’s health clinics, including centers in Greenport and Riverhead.
A nonprofit funded primarily through Medicaid reimbursements, it offers new patients — like those who attend its Days of Health — a free clinic visit to start. The cost of additional visits — which can include dentistry, family medicine, pediatric and geriatric services, nutritional counseling, behavioral health and women’s health — is determined on a sliding scale, but can start at as little as $15, HRHCare employee Jeffrey Palmer said. Mr. Palmer added that HRHCare plans to hold more events like Friday’s Day of Health, but has not yet set any official dates.
These health care programs also extend to the immigrants’ spouses and children over age 18. Sister Margaret said that anyone 18 or younger, regardless of immigration status, receives preventive insurance through the state.
Currently, there are a few health care options for undocumented immigrants, including Emergency Medicaid, which offers payment assistance to people who meet income criteria — regardless of legal status — in the event of an emergency medical condition. According to the New York State Department of Health, emergency medical conditions include an emergency labor and delivery, an event causing a serious impairment or dysfunction of a body part or an incident that puts a person’s health in “serious jeopardy.”
Carl Gabrielsen, owner of Gabrielsen Farms in Jamesport, said his workers — who are legal, mostly through the H-2A visa program — often don’t receive proper health care because it’s too expensive. He added that a worker asked him just recently what the dentist was like because he had never been to one.
Being aware of this issue, Mr. Gabrielsen said he helps his workers with some medical bills, but can’t afford to provide all his employees, many whom are seasonal, with full health coverage.
Alethea Damianos, a co-owner of Pindar Vineyards, stressed the importance of ensuring that everyone in the agricultural industry is able to remain healthy.
“We’re part of farming and it’s part of the community, and I feel that we want to help our community and help the people that are out here,” she said.
Photo Caption: HRHCare community health worker Rafael Molina takes the blood pressure of farm worker David Miguel of Cutchogue. (Credit: Barbaraellen Koch)
Editor’s note: A previous version of this article called Hudson River Healthcare Hudson Riverhead Healthcare.