I
106TH CONGRESS
2D SESSION
H. R. 4282
To provide Federal reimbursement for indirect costs relating to the incarcer-
ation of illegal aliens and for emergency health services furnished to
undocumented aliens.
IN THE HOUSE OF REPRESENTATIVES
APRIL 13, 2000
Mr. BILBRAY (for himself and Mr. HUNTER) introduced the following bill;
which was referred to the Committee on the Judiciary, and in addition
to the Committee on Commerce, for a period to be subsequently deter-
mined by the Speaker, in each case for consideration of such provisions
as fall within the jurisdiction of the committee concerned
A BILL
To provide Federal reimbursement for indirect costs relating
to the incarceration of illegal aliens and for emergency
health services furnished to undocumented aliens.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ‘‘State Criminal Alien
Assistance Program II and Local Medical Emergency Re-
imbursement Act’’.
TITLE I—STATE CRIMINAL
ALIEN ASSISTANCE PROGRAM II
SEC. 101. SHORT TITLE.
This Act may be cited as the ‘‘State Criminal Alien
Assistance Program II Act of 2000’’.
SEC. 102. FINDINGS AND PURPOSES.
(a) FINDINGS.—Congress makes the following find-
ings:
(1) Federal policies and strategies aimed at
curbing illegal immigration and criminal alien activ-
ity implemented along our Nation’s southwest border
influence the number of crossings, especially their lo-
cation.
(2) States and local governments were reim-
bursed approximately 60 percent of the costs of the
incarceration of criminal aliens in fiscal year 1996
when only 90 jurisdictions applied for such reim-
bursement. In subsequent years, the number of local
jurisdictions receiving reimbursement has increased.
For fiscal year 1999, 280 local jurisdictions applied,
and reimbursement amounted to only 40 percent of
the costs incurred by those jurisdictions.
(3) Certain counties, often with a small tax-
payer base, located on or near the border across
from sometimes highly populated areas of Mexico,
suffer a substantially disproportionate share of the
impact of criminal illegal aliens on its law enforce-
ment and criminal justice systems.
(4) A University of Arizona study released in
January 1998 reported that at least 2 of the 4 coun-
ties located on Arizona’s border of Mexico, Santa
Cruz and Cochise Counties, are burdened with this
problem—
(A) for example, in 1998, Santa Cruz
County had 12.7 percent of Arizona’s border
population but 50 percent of alien crossings and
32.5 percent of illegal alien apprehensions;
(B) for fiscal year 1998, it is estimated
that, of its total criminal justice budget of
$5,033,000, 
Santa 
Cruz 
County 
spent
$1,900,000 (39 percent) to process criminal il-
legal aliens, of which over half was not reim-
bursed by Federal monies; and
(C) Santa Cruz County has not obtained
relief from this burden, despite repeated ap-
peals to Federal and State officials.
(5) In the State of Texas, the border counties
of Cameron, Dimmit, El Paso, Hidalgo, Kinney, Val
Verde, and Webb bore the unreimbursed costs of ap-
prehension, prosecution, indigent defense, and other
related services for criminal aliens who served more
than 142,000 days in county jails.
(6) Throughout Texas nonborder counties bore
similar unreimbursed costs for apprehension, pros-
ecution, indigent defense, and other related services
for criminal aliens who served more than 1,000,000
days in county jails.
(7) The State of Texas has incurred substantial
additional unreimbursed costs for State law enforce-
ment efforts made necessary by the presence of
criminal illegal aliens.
(8) The Federal Government should reimburse
States and units of local government for the related
costs incurred by the State for the imprisonment of
any illegal alien.
(9) According to data from the Immigration
and Naturalization Service, 27 percent of all Border
Patrol apprehensions along the U.S.-Mexico border
in fiscal year 1999 took place in the San Diego and
El Centro sectors of California. Yet, those counties
were reimbursed for only a fraction of the expenses
associated with the criminal activity of illegal aliens.
(10) It is estimated that it costs in excess of
$50,000,000 to San Diego and Imperial County hos-
pitals to treat undocumented individuals in emer-
gency rooms. In October of 1997 the California
State Auditor issued a report that estimated be-
tween $4,900,000 and $8,100,000 of unreimbursed
medical expenses were incurred by U.S. Border Pa-
trol ‘‘dumping’’.
(11) One example of costs incurred by health
providers involved an overturned van containing 20
undocumented persons in Imperial County. One of
the victims involved a young man who suffered head
trauma. This patient never regained consciousness
and the costs of his care were magnified by treating
him at an acute level, as placement to a lower level
of care was not possible. The cost of providing care
for this patient alone was in excess of $200,000.
(b) PURPOSE.—The purpose of this title is—
(1) to assist States and local communities by
providing financial assistance for expenditures for il-
legal juvenile aliens, and for related costs to States
and units of local government that suffer a substan-
tially disproportionate share of the impact of crimi-
nal illegal aliens on their law enforcement and crimi-
nal justice systems; and
(2) to ensure equitable treatment for those
States and local governments that are affected by
Federal policies and strategies aimed at curbing ille-
‘‘(2) indigent defense; and
‘‘(3) unsupervised probation costs.’’; and
(3) by amending subsection (d) to read as fol-
lows:
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There
are authorized to be appropriated $200,000,000 to carry
out subsection (a) for each of the fiscal years 2001
through 2004.’’.
SEC. 104. REIMBURSEMENT OF STATES AND POLITICAL
SUBDIVISIONS FOR COSTS OF INCARCER-
ATING JUVENILE ALIENS.
(a) IN GENERAL.—Section 501 of the Immigration
Reform and Control Act of 1986 (8 U.S.C. 1365), as
amended by section 103 of this Act, is further amended—
(1) in subsection (a)(1), by inserting ‘‘or illegal
juvenile alien who has been adjudicated delinquent
or committed to a juvenile correctional facility by
such State or locality’’ before the semicolon;
(2) in subsection (b), by inserting ‘‘(including
any juvenile alien who has been adjudicated delin-
quent or has been committed to a correctional facil-
ity)’’ before ‘‘who is in the United States unlaw-
fully’’; and
(3) by adding at the end the following:
‘‘(f) JUVENILE ALIEN DEFINED.—In this section,
the term ‘juvenile alien’ means an alien (as defined in sec-
tion 101(a)(3) of the Immigration and Nationality Act)
who has been adjudicated delinquent or committed to a
correctional facility by a State or locality as a juvenile of-
fender.’’.
(b) ANNUAL REPORT.—Section 332 of the Illegal Im-
migration Reform and Immigrant Responsibility Act of
1996 (8 U.S.C. 1366) is amended—
(1) by striking ‘‘and’’ at the end of paragraph
(3);
(2) by striking the period at the end of para-
graph (4) and inserting ‘‘; and’’; and
(3) by adding at the end the following:
‘‘(5) the number of illegal juvenile aliens (as de-
fined in section 501(f) of the Immigration Reform
and Control Act) that are committed to State or
local juvenile correctional facilities, including the
type of offense committed by each juvenile.’’.
(c) 
CONFORMING
AMENDMENT.—Section
241(i)(3)(B) of the Immigration and Nationality Act (8
U.S.C. 1231(i)(3)(B)) is amended—
(1) by striking ‘‘or’’ at the end of clause (ii);
(2) by striking the period at the end of clause
(iii) and inserting ‘‘; or’’; and
(3) by adding at the end the following:
‘‘(iv) is a juvenile alien with respect to
whom section 501 of the Immigration Re-
form and Control Act of 1986 applies.’’.
SEC. 
105. 
REIMBURSEMENT 
OF 
STATES 
BORDERING
MEXICO OR CANADA.
Section 501 of the Immigration Reform and Control
Act of 1986 (8 U.S.C. 1365), as amended by sections 103
and 104 of this Act, is further amended by adding at the
end the following new subsection:
‘‘(g) MANNER
OF
ALLOTMENT
OF
REIMBURSE-
MENTS.—Reimbursements under this section shall be al-
lotted in a manner that takes into account special consid-
eration for any State that—
‘‘(1) shares a border with Mexico or Canada; or
‘‘(2) includes within the State an area in which
a large number of undocumented aliens reside rel-
ative to the general population of the area.’’.
TITLE II—REIMBURSEMENT OF
STATES AND LOCALITIES FOR
EMERGENCY HEALTH SERV-
ICES 
TO 
UNDOCUMENTED
ALIENS
SEC. 201. AUTHORIZATION OF ADDITIONAL FEDERAL REIM-
BURSEMENT OF EMERGENCY HEALTH SERV-
ICES 
FURNISHED 
TO 
UNDOCUMENTED
ALIENS
(a) TOTAL AMOUNT AVAILABLE FOR ALLOTMENT.—
To the extent of available appropriations under subsection
(e), there are available for allotments under this section
for each of fiscal years 2002 through 2005, $200,000,000
for payments to certain States under this section.
(b) STATE ALLOTMENT AMOUNT.—
(1) IN GENERAL.—The Secretary shall compute
an allotment for each fiscal year beginning with fis-
cal year 2001 and ending with fiscal year 2004 for
each of the 17 States with the highest number of
undocumented aliens. The amount of such allotment
for each such State for a fiscal year shall bear the
same ratio to the total amount available for allot-
ments under subsection (a) for the fiscal year as the
ratio of the number of undocumented aliens in the
State in the fiscal year bears to the total of such
numbers for all such States for such fiscal year. The
amount of allotment to a State provided under this
paragraph for a fiscal year that is not paid out
under subsection (c) shall be available for payment
during the subsequent fiscal year.
(2) DETERMINATION.—For purposes of para-
graph (1), the number of undocumented aliens in a
State under this section shall be determined based
on estimates of the resident illegal alien population
residing in each State prepared by the Statistics Di-
vision of the Immigration and Naturalization Service
as of October 1992 (or as of such later date if such
date is at least 1 year before the beginning of the
fiscal year involved).
(c) USE OF FUNDS.—
(1) IN GENERAL.—From the allotments made
under subsection (b) for a fiscal year, the Secretary
shall pay to each State amounts described in a State
plan, submitted to the Secretary, under which the
amounts so allotted will be paid to local govern-
ments, hospitals, and related providers of emergency
health services to undocumented aliens in a manner
that—
(A) takes into account—
(i) each eligible local government’s,
hospital’s or related provider’s payments
under the State plan approved under title
XIX of the Social Security Act for emer-
gency medical services described in section
1903(v)(2)(A) of such Act (42 U.S.C.
1396b(v)(2)(A)) for such fiscal year; or
(ii) an appropriate alternative proxy
for measuring the volume of emergency
health services provided to undocumented
aliens by eligible local governments, hos-
pitals, and related providers for such fiscal
year; and
(B) provides special consideration for local
governments, hospitals, and related providers
located in—
(i) a county that shares a border with
Mexico or Canada; or
(ii) an area in which a large number
of undocumented aliens reside relative to
the general population of the area.
(2) SPECIAL RULES.—For purposes of this sub-
section:
(A) A provider shall be considered to be
‘‘related’’ to a hospital to the extent that the
provider furnishes emergency health services to
an individual for whom the hospital also fur-
nishes emergency health services.
(B) Amounts paid under this subsection
shall not duplicate payments made under title
XIX of the Social Security Act for the provision
of emergency medical services described in sec-
tion 1903(v)(2)(A) of such Act (42 U.S.C.
1396b(v)(2)(A)).
(d) DEFINITIONS.—In this section:
(1) HOSPITAL.—The term ‘‘hospital’’ has the
meaning given such term in section 1861(e) of the
Social Security Act (42 U.S.C. 1395x(e)).
(2) PROVIDER.—The term ‘‘provider’’ includes
a physician, another health care professional, and an
entity that furnishes emergency ambulance services.
(3) SECRETARY.—The term ‘‘Secretary’’ means
the Secretary of Health and Human Services.
(4) STATE.—The term ‘‘State’’ means the 50
States and the District of Columbia.
(e) AUTHORIZATION OF APPROPRIATIONS.—There is
authorized to be appropriated to carry out this section
$200,000,000 for each of fiscal years 2001 through 2005.
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