Crossing Los Angeles, the Inland Empire and the Coachella Valley, one community health center is expanding its services to immigrant patients in their homes after realising that people are skipping critical medical appointments as they fear people will venture out.
St. John’s Community Health, one of Los Angeles County’s largest nonprofit community health care providers, launched its housing visit program in March after learning that patients were missing out on a routine, emergency care appointment.
Serving through a network of clinics and mobile units throughout the region, St. John’s estimates that at least 25,000 patients are undocumented, with about a third of them suffering from chronic conditions, including diabetes and hypertension, requiring routine testing. However, these patients had no tests to monitor their glucose and blood pressure, and they had also made appointments to pick up prescription refills.
Earlier this year, the health center began investigating patients, finding that hundreds of people have “canceled their appointments just because they are afraid of being arrested by the ice.
President Trump has pledged to the largest deportation effort in US history, coming to a second term in which he initially focused his rhetoric on undocumented immigrants who committed violent crimes. But shortly after he took office, his administration said it didn’t think it was a criminal by anyone in the country.
For the next few months, the new administration has used a variety of tactics to soothe fear of the immigrant community. The Department of Homeland Security has launched an advertising campaign to encourage people across the country without approving the risk of resignation or deportation. Immigration agents appear at Home Depot and at court looking for people in the US without approval. More and more, detained migrants are being slurped and deported to their home countries, or in some cases, to countries they have no connection to.
In January, the Trump administration rescinded a policy that once protected sensitive areas such as hospitals, churches and schools from immigration-related arrests.
In response to the findings, St. John’s launched a healthcare program without a fear program to reach patients who are afraid to leave the house. St. John’s CEO and President Jim Manzia said in a statement that providers should implement policies to ensure care is available to all patients, regardless of the immigration situation.
“Healthcare is a human right, and we don’t allow fear to get in the way,” he said.
Bucola Orsanya, a nurse practitioner and head of regional medical care at St. John’s, said one woman reported that she hadn’t left the house in three months. She said she knows other patients with chronic illnesses who haven’t left their home due to exercise that could make their illness worse. Even some US immigrants have legally expressed reservations. Considering news articles that the government has accused it of a crime and deported it without legitimate proceedings.
Olusanya said she waits for people to come back for their own medical care, considering how quickly their condition can deteriorate. “It could be complicated to get a barrier that lasts for life, and they either become more dependent or they need to use more resources,” she said. “So why not prevent that?”
On a recent Thursday at St. John’s Avalon Clinic in South Los Angeles, Orsanya prepared to head to the patient’s home, which lived about 30 minutes away. The Avalon Clinic serves a large population of homeless patients and has a street team that frequently uses vans filled with medical equipment. Vans prove to be useful for home visits.
Olusanya spent about 30 minutes preparing for the 3pm appointment, assembled equipment, blood was collected, urine samples were collected, and checked the patient’s vitals and glucose levels. She said physical examinations were conducted in the bedroom and living room depending on the patient’s housing situation and privacy.
She recalled a similar decline in patient visits when he vowed to massive deportation during Trump’s first administration. At the time, she said that St. John’s staff had drills in preparation for a potential federal attack and tied weapons to human chains to block the entrance to the clinic.
But this time, the fear is more obvious, she said. “You feel it. It’s very thick,” she said.
Telehealth is an option for some patients, but many people need in-person care. St. John’s dispatches a team of three or four staff members to call the house, and is generally welcomed with a combination of valuable relief and gratitude.
“They are very happy, ‘Oh, my God, St. John can do this, and I am very grateful,” she said. “So that means a lot.”
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