In response to growing anxieties within immigrant communities, a california health center is now providing at-home medical services to patients too fearful to attend crucial appointments. This initiative spans across Los Angeles, the Inland Empire, and the Coachella Valley.

After noticing a meaningful drop in patient attendance, St. John’s Community Health, a major nonprofit healthcare provider in Los Angeles County serving low-income and working-class individuals, launched its home visitation program in March. The program addresses the rising number of patients who were missing both routine and urgent medical appointments, driven by fears of potential encounters with U.S. Immigration and Customs Enforcement agents.

St. John’s estimates that approximately 25,000 of its patients are undocumented, with about one-third managing chronic conditions such as diabetes and hypertension. Regular check-ups are vital for these patients, but many were skipping essential blood sugar and blood pressure monitoring, and also prescription refills.

According to the health center, surveys conducted earlier in the year revealed that hundreds of patients were canceling appointments “solely due to fear of being apprehended by ICE.”

The current administration has pledged a large-scale deportation campaign, initially focusing on undocumented immigrants accused of violent crimes. However, shortly after taking office, the administration broadened its stance to include anyone in the country without authorization as a criminal.

since then, various tactics have been employed to instill fear within immigrant communities. The department of Homeland Security initiated an ad campaign encouraging unauthorized individuals to leave the country or risk deportation. Immigration agents have been reportedly appearing at locations like Home Depots and even courtrooms, seeking out undocumented individuals. Detained immigrants are increasingly being deported swiftly, sometimes to countries where they have no connections, often without the chance to gather belongings or say goodbye to family.

In January, the administration revoked a policy that had previously protected sensitive locations such as hospitals, churches, and schools from immigration arrests.

In response to the survey findings, St. John’s introduced the Health Care Without Fear program to reach those afraid to leave their homes. Jim Mangia, chief executive and president of St. John’s, stated that healthcare providers should adopt policies ensuring access to care for all patients, irrespective of immigration status.

“Healthcare is a human right – we will not allow fear to stand in the way of that,” he said.

Bukola Olusanya, a nurse practitioner and the regional medical director at St. John’s, mentioned that one patient had not left her home in three months. She also noted that some patients with chronic conditions were avoiding exercise, which could worsen their health. Even immigrants with legal status are expressing concerns, given reports of individuals being accused of crimes and deported without due process.

Olusanya explained that waiting for patients to return for medical care independently was too risky, considering the potential for rapid deterioration of their conditions.”It could be a complication that’s going to make them get a disability that’s going to last a lifetime,and they become so much more dependent,or they have to use more resources,” she said. “So why not prevent that?”

Recently, at St. John’s Avalon Clinic in South L.A., Olusanya prepared for a home visit to a patient living about 30 minutes away. The Avalon Clinic, which serves a large homeless population, utilizes a street team with a van equipped with medical supplies, which has proven valuable for these home visits.

Olusanya spent approximately 30 minutes preparing for the appointment, gathering equipment for blood draws, urine samples, and vital signs and glucose level checks. She noted that physical exams are conducted in bedrooms or living rooms,depending on the patient’s living situation and privacy.

She recalled a similar decline in patient visits during a previous administration when mass deportations were also threatened. At that time, St. John’s staff conducted drills to prepare for potential federal raids, forming human chains to block clinic entrances.

Tho, Olusanya noted that the current level of fear is more intense. “You feel it; it’s very thick,” she said.

While telehealth is an option for some, many patients require in-person care. St. John’s dispatches teams of three or four staff members for house calls, which are generally met with relief and gratitude.

“They’re very happy like, ‘Oh, my God, St. John’s can do this. I’m so grateful,’ ” she said. “So it means a lot.”