As Immigration and Customs Enforcement raids increased dramatically over the past two months, community health clinics saw a substantial drop in client visits.
“We’ve been hearing all these rumors that there will be an increased ICE presence in Los Angeles,” said Dr. Jose Perez, Chief Medical Officer at the South Central Family Health Center. “So clearly it has rattled the community. That’s what’s preventing folks from coming in. They don’t really know if ICE is active, when ICE will come, and where they are going. And so rather than risk it, they just don’t come into the clinic,” he said in an interview with Ethnic Media Services.
Such fears are not unfounded. Perez noted reports of ICE vans in February parked outside a community health clinic in Adelanto, California. Though agents did not go into the facility, the tacit threat was enough to keep many clients away.
The drop in client visits comes amid the quad-demic of influenza, bird flu, RSV, and Covid-19. The US is facing the worst flu season it has experienced in 15 years. The Centers for Disease Control and Prevention report 37 million infections as of February 25, with 480,000 hospitalizations, and 21,000 deaths. Ninety-eight children have died of influenza this season.
The South Central Family Health Center serves 34,000 clients. About 1/3 are newer immigrants. In a normal year, the clinic would host 117,000 client visits. Nationally, 1400 Federally Qualified Health Centers serve approximately 31 million people.
In this interview, Perez spoke about the challenges of ensuring his clients get the care they need amid fears of deportation.
Dr. Perez, have you seen a significant drop-off in the number of people that are now coming to the clinic?
Yes. Given the current situation, they’re becoming afraid of coming into the clinic. The clinic has made available more telehealth visits for patients that do not want to come in. And so we are seeing an uptick a little bit in our telehealth. But the reality is that our patients, when they don’t come to the clinic, they just forego medical care altogether.
We’ve had extensive discussions at a leadership level. Obviously, as a federally qualified health center, we need to abide by laws and regulations. For example, abiding by immigration rules may come in conflict with HIPAA rules. So what our organization has decided is that once patients have been processed and are in the back office, then all the HIPAA rules that we are mandated to follow come into effect.
We are a private company. So in order for ICE agents to enter any other areas beyond the waiting area, they must have some kind of a legal document stating why they’re there and who they’re there for. They are not allowed to look at anybody else’s charts or anybody else’s medical information. And that is how we protect our patients and protect the organization from breaking HIPAA rules.
You mentioned that parents are not bringing in their children, even those who are documented or hold US citizenship. And we’re on the cusp of a measles outbreak in Texas and New Mexico.
Yes, absolutely. If a parent is afraid to come to the clinic for their own sake, bringing their child brings with it the same sort of danger. So American-born children forego vaccinations, forego physical exams. And so we put our own American citizens in danger when that comes around.
Additionally, a lot of these folks who are applying for green cards and changes in status remember four years ago with the public charge rule. Anybody getting healthcare or getting any kind of help is considered “undesirable” to get a green card, even folks who have been living here for years and are documented.
So now they may not reapply to Medi-Cal. They may not use their Medi-Cal because they don’t want any record of their use of a benefit that they are entitled to legally to come back and bite them and prevent them from obtaining their immigration status adjusted. And so it is a big burden on our patients.
We are doing all we can to educate our patients what their rights are and what folks in the government can and cannot do. And our hope is that it has an impact, that they trust us enough to come in, get their health care and even get their health care via telehealth and use whatever tools are available so we can at least give them guidance as to how to treat their ailments.
We are amid a quad-demic. Given the significant drop-off in client visits, what would you say about the overall health of your community right now?
I’ve been in the community health center realm for the last 25 years since I graduated from residency. Back in the late 1990s, we had a program called the Public Private Partnership in LA County. This was the LA County’s efforts to provide medical services to the uninsured.
Because we recognize that public health doesn’t stop by immigratory status. If somebody gets RSV, if somebody gets tuberculosis, if somebody has diabetes and winds up in our emergency rooms, you know, having a heart attack, that has no bearing on immigratory status.
‘Viruses do not understand immigratory status’
And we know that the benefits of providing health care to the entire community, regardless of immigratory status, benefits us all. The viruses, bacteria do not understand immigratory status. And so over the last 25-plus years, we’ve seen such an advance in the way that we treat people. We went from the PPP to My Health LA, and then finally we ended up with universal access to medical care via state law.
All of that is being wiped off in front of our eyes. And so my biggest fear is that folks are going to go without care. They’re going to show up at emergency rooms, which is the most costly type of health care that you can ever receive.
Costly ER visits
And so that not only is going to have an impact in the health care and the well-being of our community, but it’s going to be even more costly. I mean, we complain about the amount of money that we currently spend on health care. This has only the potential of making that even worse.
And so to me, it’s a sad thing to see that my entire work over the last 24 years advocating for better health care for everybody is being wiped out.
But the fight goes on. With our partner clinics, we’ll continue to do what we need to do to support our patients, regardless of their immigration status.
