Introduction to the Issue
For years after her diabetes diagnosis, a patient at St. John’s Community Health had kept her blood sugar levels in check. Then, federal immigration raids intensified across the region. She stayed home, fearing federal agents would detain her. The patient didn’t go to the grocery store to buy food and ate what was in her home — tortillas and coffee — for five days. Eventually, she canceled one of her regular appointments at a St. John’s clinic.
The Impact on Medical Clinics
Staff with the health network, which operates 28 locations in Los Angeles County and the Inland Empire, called the patient and offered to do the appointment at her home, a new service that St. John’s launched last month in response to heightened concerns around immigration raids. Medical staff took her blood sugar levels. She was on the verge of falling into a diabetic coma, said Jim Mangia, president and CEO of St. John’s. “Thank God we got there before she had serious injury,” Mangia said. “That’s why it’s so important we provide this support.”
No-Show Rates
In the weeks since federal immigration raids have heightened, Mangia said appointment cancellation and no-show rates jumped to 30% across all St. John’s clinics in and around Los Angeles and the Inland Empire. Typically, only about 8% to 9% of patients cancel or don’t go to appointments. Undocumented immigrants and citizens alike are staying home out of fear that they could be detained by federal immigration authorities, St. John’s health officials say.
Response to the Crisis
When Trump took office in January, he also quickly stripped a Biden-era rule that protected hospitals, clinics, houses of worship, schools and other “sensitive locations” from immigration raids. In response, St. John’s is meeting its patients where they’re at. If a patient doesn’t show up to their appointment, the clinic calls to see if they’d like to transition to a telehealth appointment. When an in-person appointment is needed, a doctor, nurse and medical assistant can also see patients at their homes through the Healthcare Without Fear program launched last month.
The Mission of St. John’s
It’s the mission of St. John’s — a federally qualified network of nonprofit health centers and several mobile clinics that serve around 25,000 undocumented patients — to provide care for anyone, Mangia said. “It’s a moral reflection of who St. John’s is,” Mangia said. “We believe that folks have a right to health care.” When she clocks in at a St. John’s clinic in South Los Angeles, Dr. Olusanya Bukola sees the impact of recent immigration raids.
The Impact on Public Health
Typically, the waiting room is filled with patients and crowds pouring into the parking lot and more than a dozen people lining up for walk-ins. Now, Bukola said just a handful of patients are at the clinic each morning. When patients fear going to their doctor’s appointments, Bukola said it can disrupt their health and, in some cases, create public health concerns. A canceled or skipped appointment could mean that a patient with a chronic condition can’t get the care they need, a child can’t be vaccinated or that patients can’t get STI testing and other important screenings.
Community Clinic Association of Los Angeles County
The Community Clinic Association of Los Angeles County, a coalition of nonprofit community health centers like St. John’s, is monitoring the impact of federal immigration enforcement across the county. So far, no-show and cancellation data from member clinics haven’t shown a clear trend, but the association’s president and CEO Louise McCarthy said that’s to be expected, given the size of L.A. and the varying populations that different clinics serve. McCarthy said the association is working with partners to further assess the data to search for patterns among clinics across the county.
Incident with Federal Immigration Authorities
Last week, a St. John’s mobile clinic had a run-in with federal immigration authorities in Downey, Mangia said. Patients lined up for services when unmarked vehicles and armed agents approached, Mangia said. Clinic staff and security closed the gates and told agents they’d need to see a warrant signed by a judge before they would let immigration authorities inside. News spread to community members, who came out to protest their presence and film the authorities, and eventually the agents left.
Proposed Government Funding Cuts
At the same time, clinics like St. John’s are fighting proposed government funding cuts, including a proposal from Gov. Gavin Newsom to roll back Medi-Cal funding for undocumented people to offset a projected $12 billion state budget deficit. Newsom’s proposed cuts would gut $53 million from St. John’s annual budget, Mangia said. Mangia plans to host a town hall with elected officials next week ahead of the June 27 deadline for lawmakers to finalize a state budget.
Conclusion
Community health clinics have made strides in Los Angeles County to provide care to more and more people, McCarthy said, but looming budget cuts could threaten that progress. “We are in terrifying times,” McCarthy said, “when it comes to trying to predict what our future looks like.” The situation highlights the need for continued support and protection for vulnerable communities, ensuring they can access necessary healthcare without fear of persecution or detention.
FAQs
- Q: What has been the impact of federal immigration raids on medical clinics in LA and the Inland Empire?
A: The raids have led to a significant increase in no-show rates, with some clinics experiencing a jump to 30% from the typical 8% to 9%. - Q: How are clinics responding to the crisis?
A: Clinics are offering telehealth appointments and home visits for patients who fear attending in-person appointments due to immigration concerns. - Q: What is the mission of St. John’s Community Health?
A: St. John’s mission is to provide healthcare to anyone, regardless of their immigration status, reflecting a moral commitment to healthcare as a right. - Q: What are the potential public health concerns arising from skipped appointments?
A: Skipped appointments can lead to uncontrolled chronic conditions, missed vaccinations, and undiagnosed STIs, posing public health risks. - Q: How are community clinic associations responding to the situation?
A: Associations are monitoring the impact, assessing data for trends, and partnering with legal aid and advocacy groups to support clinics and patients.
