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Alma Castel De Oro, health coordinator at El Rio Community Health Center and the Mexican Consulate, holds Grisela Bustamante's 7-month-old baby, who has Down syndrome. She helped the baby get heart surgery. BELOW: Castel De Oro (standing) with Maria De La Cruz, 44, (feeding child) at a free luncheon aimed at reducing diabetes among Hispanics.

What is Ventanilla de Salud?

The Ventanilla de Salud program was created in southern California in 2004 after a study by The California Endowment showed many migrant families had lived in California for at least 10 years and had no health insurance.

In Los Angeles and San Diego, Ventanilla sponsors are the Mexican government and two local nonprofits.

Collaborators include the Los Angeles County Health Department.

Ventanilla de Salud programs — now in 11 U.S. cities — aim to get Hispanics enrolled in health care to reduce the human and financial cost of serious, chronic conditions such as diabetes, which can lead to blindness, heart disease and amputation, and is more prevalent among Hispanics, according to Alma Castel de Oro, Tucson's Ventanilla health coordinator.

The Tucson Ventanilla program's monthly schedule of events is posted on the Mexican Consulate's Web site: http://portal.sre.gob.mx/tucson.

By the Numbers

• About 60,000 undocumented immigrants live in Tucson

Based on statewide population figures

• Hispanics in the United States are twice as likely to have diabetes than Caucasians.

Source: Pfizer's Alliance for a Healthy Border

• Economic output from all noncitizens, mostly undocumented workers, in Arizona: $29 billion

• Cost to Arizona for all immigrants (legal and undocumented) for health care (excluding bad debts), law enforcement and English-language education: $1.4 billion

Source: "The Economic Impact of Immigrants in Arizona," by Judith Gans, manager, Immigration Policy Program, Udall Center for Studies in Public Policy, University of Arizona. Figures based on 2004 census figures

Ventanilla de Salud's Daily Outreach

In Tucson: 70

Ventanilla Outreach in Other Cities:

Chicago; Los Angeles: 800 

Houston; McAllen, Texas: 400

New York City; San Diego: 350

Atlanta; El Paso, Texas: 300

Health Care Program Helping Hispanics

Citizenship not required; Mexico a co-sponsor

TUCSON (By Sheryl Kornman, Tucson Citizen ) December 4, 2007 — Everyone raises a hand when Carmen Ramirez asks — in Spanish — the 50 or so lunch guests at a West Side neighborhood center if they know someone with diabetes.

Ramirez is a health educator at the Arizona Department of Health Services.

These Spanish speakers, moms with babies, grandparents, too, are part of the target market in Tucson for Ventanilla de Salud.

The binational “Window of Health” initiative is co-sponsored by the Mexican government’s foreign ministry and, in Tucson, by El Rio Community Health Center through its El Rio Foundation.

The program encourages the enrollment of Hispanics, including undocumented immigrants, in sliding-fee health care services offered at the nonprofit health center, 839 W. Congress St.

The goal of Ventanilla, according to the Mexican government, is to improve the health of Hispanics of Mexican descent.

Ventanillas here and in other states offer health education programs to combat diabetes, obesity and heart disease. They also help Hispanics sign up for medical care.

In some cases, they help arrange medical care south of the border.

El Rio,which agreed to sponsor the program with the Mexican government here, provides health care to anyone, regardless of citizenship status.

Clients pay fees to the nonprofit medical facility based on their incomes for medical, dental, maternity and other services.

Jill Rodriguez, El Rio’s development coordinator, said improving the health of children and adults is an issue “without borders.”

Ventanilla in Tucson is designed to help people understand what is available on both sides of the border, she said.

“This is not about giving away medical care to people,” she said. “It’s about understanding how medical care works and being humane in how people access medical care.”

To those who object to providing health care to people who are not legal residents of the United States, she says: “We have to come together as a community. We’re not just a community health center on the other side of the fence.

“I wish we had the staff so we could go door to door and ask, ‘Do you have a doctor?’ “

The diabetes education lunch and “chat” last month took place during National Diabetes Prevention Month.

The meal, at El Pueblo Neighborhood Center, featured refried beans made without lard, a mixed green salad, fresh fruit and carne asada cooked without added fat.

The food was donated by Food City, an Arizona grocer that markets to Hispanics.

The Tucson-Mexico Ventanilla program got under way quietly here on the West Side about 20 months ago.

Patti Woodcock, spokeswoman for the Pima County Health Department, said county health officials were not aware of it until recently and had no “official” comment on it, she said.

The county also provides some health-care services to residents here regardless of citizenship status.

“Communicable disease doesn’t recognize borders,” she said.

“We ask only for an address and provide public health services to anyone, regardless of documentation,” she said.

Woodcock said county medical professionals don’t ask questions about citizenship when they offer HIV/AIDS testing, tuberculosis screening or vaccines for children and adults. Preventing the spread of communicable diseases is the goal.

The Mexican Consulate in Tucson, with funds provided by the Mexican government, pays $30,000 a year for Ventanilla de Salud’s outreach efforts here. El Rio Foundation pays $30,000 a year to run the Ventanilla program in Tucson.

Ventanilla reaches about 1,500 people a year in health promotion programs around town, at El Rio’s eligibility offices and through the Mexican Consulate, which refers people to Ventanilla.

Gifts from donors, including pharmaceutical giant Pfizer, help El Rio expand the reach of Ventanilla’s preventive health programs.

Ventanilla’s full-time health coordinator, Alma Castel De Oro, works two days a week at the Mexican Consulate, 553 S. Stone Ave., and three days a week at El Rio Health Center.

Castel De Oro, a former hospital eligibility worker with more than 20 years of experience in health care in Tucson, helps anyone who asks about access to health care and helps people find out which programs they’re eligible for.

“To have access to health care, you don’t have to have your legal status,” she said.

Castel De Rio said she tells people who are not legal residents of Arizona they can can get health services at El Rio.

Vitamin world has come up with various ways to deal with carcinomas of breasts. We know the patients have to suffer hair loss and often lose weight during the treatment. Many resolve these issues with skin care products and some have to rely on cosmetic surgery as well.

Community health centers, historically located in medically underserved areas, “accept everybody,” said Tara McCollum Plese, director of government and media relations for the Arizona Association of Community Health Centers.

McCollum Plese said keeping migrants healthy is a public health issue.

“Keeping them healthy keeps our whole population healthy,” she said.

“We can’t forget many of the children being served at community health centers are U.S. citizens. That often gets lost in the discussion.”

Castel De Oro said she often talks with “mixed” families — the children are U.S. citizens and one or more parent is not. Children born in the U.S. of noncitizens are automatically U.S. citizens.

“What I’m hearing anecdotally is that a lot of these families are afraid” to come in at all (for health care services), even if the children are U.S. citizens and eligible for state-funded care, McCollum Plese said. “We’re seeing some drop-off in the numbers of patients we see at community health centers in Arizona, from fear of a backlash and being turned in.”

Castel De Oro said she finds some Hispanics living here are afraid to seek any type of health care and some wait until they are critically ill and end up in the emergency room.

At El Rio, noncitizens can sign up for medical care, maternity care, dental care, diagnostic tests and procedures and prescription drugs just as citizens can.

“We must serve everyone who comes through the door,” McCollum Plese said of the community health centers around the state.

“There is a concern if somebody comes across the border with whooping cough or some other communicable disease that goes untreated and can then spread to others in the general population,” she said.

“Our role is not only to deliver primary health care but the preventive piece, too.

“They pay on a sliding fee scale, albeit only a small portion of what that service costs. At least they are contributing to their own health care expense. There is no state law that requires at this time for the health care provider to report to immigration authorities. It’s kind of a nice little loophole.”

 


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