Immigration arrests are up significantly since the beginning of President Donald Trump’s second term, and some health center leaders say fewer patients are coming in for routine care.
The day after Trump took office, the Department of Homeland Security (DHS) withdrew a policy preventing Immigration and Customs Enforcement (ICE) from arresting people in “sensitive” areas, including hospitals and health centers.
Of 511 lawfully present immigrants in the US KFF surveyed this spring, about 9% said they had avoided seeking healthcare since the start of the new administration.
Healthcare Brew spoke with health centers in ICE hot spots about the effects they’re seeing from increasing immigration arrests as well as steps they’re taking to ensure patients continue receiving care.
Los Angeles
The Southern California city has been a prime target of the administration’s immigration enforcement actions, with the president sending “hundreds” of National Guard soldiers there in June following protests over immigration raids.
Despite being a sanctuary city—meaning it has policies to limit its cooperation with immigration officials—ICE has made 4,163 arrests in LA since June, according to DHS data reported by ABC7 News on Aug. 7.
Louise McCarthy, president and CEO of the Community Clinic Association of Los Angeles County, which represents more than 450 clinics that treat a combined 2 million patients per year, told us the community health centers (CHCs) have seen an “uneven impact” as far as no-show rates and cancellations.
“It’s notable that people of all immigration statuses, including people who are citizens, are living in fear because of the sense that the streets are not safe for people to go out, to go to school, to go to their jobs, to get healthcare,” McCarthy said.
The clinics are spreading the word that they offer telehealth services for things like prescription refills and other care that doesn’t require an in-person visit, according to McCarthy.
“We just want to make sure that people get care,” she said.
New York City
From January through July, ICE issued 6,025 arrest requests in New York City, according to a July 23 statement from DHS.
At Community Healthcare Network, which comprises 14 CHCs in the city, President and CEO Robert Hayes told Healthcare Brew the centers are focused on spreading the message that they don’t turn anyone away based on immigration status. In fact, the health centers, which see about 65,000 patients annually, “do not and have never asked people what their immigration status is,” he said.
In Jackson Heights, Queens, which has a large immigrant population, the network has deployed mobile health programs and been “very proactive” in offering patients the option for telehealth when appropriate, Hayes added.
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“We’re trying to do everything possible to get the message to people that it is reasonably safe to come in, that it is completely unsafe to ignore your healthcare needs, and to really push things like vaccines for kids and other fundamental principles of primary healthcare,” he said.
Chicago
Though Chicago is also a sanctuary city, Cook County, Illinois, had 113,959 pending deportation cases as of March, the second highest number in the country behind Miami-Dade County, Florida, Axios reported in June.
Laura Starr, director of external affairs at CommunityHealth, which runs four CHCs in the city and sees about 4,200 patients per year, told Healthcare Brew the organization saw fewer patients coming to appointments “almost immediately after the inauguration in January.”
“Those first couple of weeks, almost 40% of our primary care appointments were no-shows,” Starr said. “A lot of people were not picking up their prescriptions from our pharmacy. We just, in general, had a pretty empty health center.”
By mid-February, the health centers were nearly back to “normal appointment adherence rates,” she said, except at the location in the Little Village neighborhood, which has a high concentration of Mexican immigrants.
All CommunityHealth staff has been trained in the Know Your Rights protocol, which informs people of their legal rights when met with law or immigration enforcement, and they regularly conduct drills, Starr added.
Florida
ICE arrested more than 10,818 people in Florida from the start of Trump’s second term through July, according to data from the Deportation Data Project, Florida Phoenix reported on July 24.
Amy Halstead, CEO of Rural Health Network of Monroe County, Florida, located in Key West, told us fewer patients are coming in for care. The clinic sees about 7,500 visits per year for both medical and dental care.
“Where we’ve seen the biggest decrease in this area has been with pregnant women,” Halstead said, noting there’s only one hospital the clinic’s patients can access for labor and delivery in Key West. “The fact that the hospital numbers are down—and all the surrounding practices aren’t seeing as many pregnant women—is telling us that it’s probably an indication of people leaving the area.”
In addition to offering telehealth, the health center has a mobile unit it takes directly into communities to make sure patients can access care.
She said it has also trained staff on what to do if immigration officials enter a clinic.
“We haven’t actually had anybody come on-site yet. We’ve seen [immigration officials] around our clinic but not actually physically walking into our clinic,” Halstead said.