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Uncertainty about U.S. immigration laws’ impact on Valley residents being transported by EMS at Border Patrol checkpoint in Falfurrias to be addressed in Edinburg on Friday, May 18 - Titans of the Texas Legislature

Featured: Med Care EMS ( holds transportation contracts for major hospital systems in deep South Texas, including Doctors Hospital at Renaissance, South Texas Health Systems, Mission Regional Medical Center, and Knapp Medical Center.

Image Courtesy of MED CARE EMS


Uncertainty about U.S. immigration laws’ impact on Valley residents being transported by EMS at Border Patrol checkpoint in Falfurrias to be addressed in Edinburg on Friday, May 18

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Representatives from the Valley’s largest hospitals, along with invited leaders of the U.S. Border Patrol and representatives for area congressmen, will meet in Edinburg on Friday afternoon, May 18, 2018, to find an appropriate path for the emergency medical transportation of patients whose immigration status is circumspect, Med Care EMS of McAllen has announced.

Circumspect means being heedful of circumstances and potential consequences.

The gathering, which is free and open to the public, will take place from 2 p.m. to 4 p.m. at the Edinburg Conference Center at Renaissance, located at 118 Paseo Del Prado in Edinburg.

Candelario Ontiveros, President/CEO of Med Care EMS in McAllen, illustrated some of the serious problems his company faces when ground ambulances reach the U.S. Border Patrol inspection complex north of the Valley.

“Our EMS drivers arrive at the Falfurrias checkpoint with a patient, who is usually in critical condition, with doctor’s orders to be transferred to a higher level of care in San Antonio, Houston or elsewhere north of the Valley,” said Ontiveros. “Our concern and focus are the streamlining and defining of the appropriate process for patients who are in life-saving care but may have questionable immigration status.”

One of the key goals for the meeting on Friday, May 18, 2018 at the Edinburg Conference Center at Renaissance “is to achieve official policy that hospitals and EMS companies can adhere to while providing the best level of care to the patient,” Ontiveros added. “None of us want to break any federal laws, but we are in the life-saving business, which means we must work quickly, efficiently and safely for the sake of our patients, their families, and the Rio Grande Valley.”

Inconsistent U.S. immigration laws can endanger the lives of their patients because of the uncertainty they create for medical professionals and health care providers, including EMS companies, said Paul M. Vazaldua, Jr., Legislative Affairs/Special Projects Director for Med Care EMS.

Officials with area hospitals have been confused about the federal rules that deal with their medical decisions to transport their patients outside of the Valley to hospitals which have advanced or specialized medical services that would be in the best interest of South Texas patients, said Vazaldua.

“Under federal law, hospital nursing staff do not ask patients their residency since health care services are provided regardless of immigration status,” Vazaldua said. “Only the patient can be transported in the ambulance. But what we are faced with is sometimes their family members want to meet their loved one at the facility where we are transporting the patient. We get this question a lot: ‘Can we follow the ambulance?’ But if those family members are undocumented immigrants, EMS has no authority to tell them to follow us. We want to identify at this meeting on Friday who is responsible – such as the physicians, hospital administrators, EMS providers – for asking the patient and/or their families for appropriate documents to cross U.S. Border Patrol checkpoints?”

Med Care EMS (, which holds transportation contracts for Doctors Hospital at Renaissance, South Texas Health System, Mission Regional Medical Center, and Knapp Medical Center, is coordinating the meeting as a public service to hospitals.

“They asked us to organize this event so that everyone involved in this very important process can have their questions answered, and share concerns and ideas, so that we can continue to save lives and heal Valley residents,” Vazaldua explained. “We have invited executives from all hospitals and emergency medical service companies from our region so they may learn about, and adhere to, all federal laws and regulations which are enforced by the U.S. Border Patrol. I’m hopeful that with this meeting we will have preemptive notifications and 24/7 points of contact for hospitals in this region.”

Med Care EMS is in the process of obtaining air ambulance licenses to provide ambulance flight service across Texas and Mexico, so similar concerns about documentation for those patients also will be discussed at the session on Friday.

“Med Care EMS is the leader in the use of the latest technology on their ambulance units as well as having critical care paramedics and units available for long-distance transfers of those patients who require a higher level of care,” Vazaldua noted

At the beginning of 2018, the issue of transporting patients past U.S. Border Patrol checkpoints became so important that it required Carla L. Provost, Acting Chief, U.S. Border Patrol, to provide some advice to all chief patrol agents and directorate chiefs.

In her memo, titled “Medical Conveyances Transiting Through Checkpoints” and dated Friday, January 5, 2018, Provost wrote the following:

“This memorandum provides guidance when dealing with medical conveyances transiting through U.S. Border Patrol immigration checkpoints.

“At certain locations, U.S. Border Patrol operates immigration checkpoints where Border Patrol agents stop motorists to engage in a brief inquiry to determine whether the individuals have a lawful basis to be in the United States. U.S. Border Patrol Checkpoint Directive OBP 50/8b-P states, in Section 2.6 that ‘No person or vehicle is exempt from inspection procedures at Border Patrol checkpoints. The only exceptions shall be in cases where health, safety or exigent circumstances exist.’

“Medical conveyances engaged in immediate emergency operations should always receive expedited transit through or around a checkpoint.

“Sector Border Community Liaisons should engage with local medical stakeholders in order to explore the possibility for preemptive notifications. Any pre-notifications made by medical staff that suggest a traveler or accompanying passenger is in the United States illegally, should be reported immediately through your chain of command for guidance.

“If a situation involves a non-urgent medical transfer, determination of alienage may be accomplished through normal processes, including through secondary inspection, if appropriate, or as operationally feasible depending on the particular circumstances of the case. At times, medical conveyances, to include those that are privately owned, arrive for inspection at the checkpoints with a passenger who is an accompanying adult, parent, relative, or spouse who is neither a patient nor part of the medical conveyance staff. These persons are not exempt from an immigration inspection, but very often factor into the decision making process of the inspection, as they may have to authorize continued critical care for the patient. Therefor, these individuals should be processed promptly when feasible along with the immediate patient and attending medical staff.

“While it is difficult to outline all types of encounters, each circumstance will need to be addressed on a case-by-case basis with guidance provided by leadership. In the event that a follow-up inspection or immigration interview of the vehicle occupants is conducted at the hospital, sectors are reminded to be cognizant and familiar with the sensitive location policies when applying this guidance.

“Please direct any questions regarding this matter to Acting Associate Chief Sandi Goldhamer at [email protected].”


The U.S. Border Patrol, a component of U.S. Custom and Border Protection within the Department of Homeland Security, plays a critical role in securing the nation’s borders between the ports of entry from: illegal immigration, illicit smuggling of humans, contraband, and terrorism, according to the federal agency.

Transportation check operations are conducted at a variety of public transportation access points including airports, seaports, rail, and bus stations, the U.S. Border Patrol further states in its brochure titled “U.S. Border Patrol Check Operations”.

Transportation check operations provide an additional enforcement posture as well as a layered enforcement approach to border security.

These transportation check operations are usually conducted accordingly:

• During transportation checks, Border Patrol agents engage in brief conversations with members of the traveling public;

• Typically, agents will ask travelers questions about immigration status, travel plans and luggage;

• To facilitate the transportation check, travelers are asked to answer the questions truthfully;

• If asked for ID or immigration documents, travelers are asked to have them available for the agent to inspect;

• In some instances, an agency may also request consent to search a traveler or their luggage;

• To protect the privacy of travelers, or for safety or other reasons, the agent may ask the travelers to exit to the side of the checkpoint facility; and

• If an agent suspects an individual is violating federal law, the agent may detain that individual for additional questioning.



For more information, please contact Paul M. Vazaldua, Jr., Legislative Affairs/Special Projects Director for Med Care EMS, at 956-668-9111.

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