The Miami Herald, Inc.; a Knight Ridder publication. One Herald Plaza, Miami, FL 33132-1693 - Thursday, October 17, 1996 Edition: Final Section: Local Page: 1B Word Count: 593
Peggy Rogers, Herald Staff Writer

"I do not want to see people driven underground," Dr. James Howell, secretary of Florida's new Department of Health, said Wednesday in Miami. "I don't want the word to get out on the street: Don't go to the health department, don't go to the community health centers."

Although the fine print and implications are still under scrutiny, a federal immigration law passed Sept. 30 appears to seek such information from all medical and mental-health centers that receive federal dollars, authorities say. That includes virtually every low-cost and free clinic in South Florida.

"That's going to be a very difficult ethical problem for medical providers -- we're trained to provide health care and not act as immigration officers," said Ann-Lynn Denker, a Jackson Memorial Hospital nurse and spokeswoman. "I don't know what I would do myself. I would tend to want to break the law."

In his speech Wednesday to local medical leaders, Howell also said state authorities have started performing background checks on all Florida workers who handle records of patients with sexually transmitted diseases. The new policy and a criminal investigation come in response to the recent release and questionable handling of HIV patient records by state health workers in Pinellas County.

"That is a crime. We're going to try to make it a higher crime," said Howell, a medical doctor who has served as HRS chief in the Palm Beach area, statewide health officer and deputy HRS secretary.

Although Howell's department does not officially split off from Florida's Department of Health and Rehabilitative Services until after Jan. 1, he has been speaking frankly in talks around the state. Florida's health-care industry is changing so rapidly that agencies no longer make five-year plans, Howell joked Wednesday, "Instead, we have five-day plans." But nothing, he said, "gets me crazier than fraud and abuse." While "some real thieves out there" making off with scarce medical dollars, millions of Florida residents lack affordable basic care, said Howell.

Government has an obligation to tend to immigrants, the poor and the general public-health, a huge challenge in urban areas like Miami, Howell said Wednesday, speaking to local medical leaders.

"I can divide my career into B.A. and A.A. -- Before AIDS and After AIDS," the veteran public-health administrator said. "And also B.C. and A.C. -- before crack cocaine and after crack cocaine. Those have been tremendous social and health issues for the past 15 years."

The latest issue: What is the government's responsibility in providing care for noncitizens?

Many local immigrants, rather than face the question that could trigger deportation, would suffer without treatment, have babies at home or seek unlicensed healers, experts said Wednesday.

Days ago, New York City sued the federal government, saying that it was unconstitutional for its medical and social services workers to surrender the names of illegal immigrants.

"If you just begin to ask the question, they will not come," said Mario Jardon, president of the nonprofit Northwest Dade Center in Hialeah, a federally financed mental health agency.

"The minute you start saying, `And, by the way, are you a citizen?' People will turn away. They will go back to living on the streets" without psychiatric care, said Jardon, chairman of the nonprofit Health Council of South Florida, which sponsored Howell's talk and will study the issue's impact in Dade.

CAPTION: photo: James Howell (a)

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