Providing preventative health care to illegal immigrants and residents without insurance is the key to their better health - and to the improved fiscal health of the territory's hospitals, according to speakers at a Schneider Regional Medical Center symposium Wednesday.

In the absence of wellness checkups and early intervention, patients are more likely to go to the emergency room with serious illnesses and long-term health complications that could have been prevented, speakers at the 18th annual Pastoral Care/Biomedical Ethics Joint Committees Symposium said.

A number of clinics run by the V.I. Health Department and nonprofits in the territory provide those preventative services - at a price that most people can afford, said Christine deJongh-Lewis, Schneider Regional director of patient relations and one of the panelists at Wednesday's symposium, which focused on challenges in caring for the indigent and immigrant population.

"I know the cost is nominal," deJongh-Lewis said.

Fear of being reported - and deported - tends to keep illegal immigrants from seeking care until they cannot put it off any longer, according to information presented at the symposium.

Lori Thompson, a clinical psychologist who chairs the hospital's Biomedical Ethics Committee, told the clergy members, health-care professionals and community members who gathered for the forum that neither the hospital nor the clinics report a person's citizenship status.

The fear that costs will be prohibitive may also keep residents who are uninsured from seeking care until a medical problem gets out of hand, panelists said. Some, knowing that they will receive care, also may also go the emergency room the way others would go to see their family physician.

"A lot of our citizens really use the emergency room as a public health clinic," deJongh-Lewis said, adding that a visit that might have a minimal cost at a clinic could balloon into hundreds of dollars at the emergency room.

At the request of an audience member, she listed out the locations of all the clinics in the territory and also pointed to health fairs as another means of obtaining free medical screenings. She asked the clergy members in the audience to distribute the information to their parishioners who may be in need of services.

"Our community has one of the highest levels of diabetes anywhere," deJongh-Lewis said. "We need to focus on prevention."

Jackie Bonnick, Schneider Regional director of admissions, said that in 2006, the hospital was strapped with an estimated $10.5 million in uncompensated care costs - the cost of footing the bill for patients without the resources to do so. In 2007, that figure rose to an estimated $11 million, she said.

A shortage of long-term care facilities in the territory is another factor that affects the cost of uncompensated care at the hospital, panelists said. While patients may be ready for discharge to a nursing home or other long-term facility, the shortage of beds may mean they stay at the hospital much longer than they need to.

For various reasons, the families of homeless patients may be unwilling or unable to provide them with a place to stay when they are discharged - again leading to an overly long hospital stay, panelists said.

"We have become a dumping ground," said Julia Odlum, a nurse case manager who attended the symposium, which was sponsored by Schneider Regional and the Virgin Islands Continuing Medical Education Committee.

Organizers said the two-day symposium, which started Tuesday, was aimed at educating the community about some of the issues the hospital faces and also at taking suggestions and recommendations from the community.

On Tuesday, the discussion focused on challenges arising from emergency air transportation off-island.