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Los Angeles Times
24-05-2025
- Health
- Los Angeles Times
Health clinics that service immigrants are making house calls on patients too afraid to leave home
Across Los Angeles, the Inland Empire and the Coachella Valley, one community health center is extending its services to immigrant patients in their homes after realizing that people were skipping critical medical appointments because they've become too afraid to venture out. St. John's Community Health, one of the largest nonprofit community healthcare providers in Los Angeles County that caters to low-income and working-class residents, launched a home visitation program in March after learning that patients were missing routine and urgent care appointments because they feared being taken in by U.S. Immigration and Customs Enforcement agents. St. John's, which offers services through a network of clinics and mobile units across the region, estimates that at least 25,000 of its patients are undocumented, and about a third of them suffer from chronic conditions, including diabetes and hypertension, which require routine checkups. But these patients were missing tests to monitor their blood sugar and blood pressure, as well as appointments to pick up prescription refills. Earlier this year, the health center began surveying patients and found that hundreds were canceling appointments 'solely due to fear of being apprehended by ICE.' President Trump came into his second term promising the largest deportation effort in U.S. history, initially focusing his rhetoric on undocumented immigrants who had committed violent crimes. But shortly after he took office, his administration said they considered anyone in the country without authorization to be a criminal. In the months since, the new administration has used a variety of tactics to sow fear in immigrant communities. The Department of Homeland Security has launched an ad campaign urging people in the country without authorization to leave or risk being rounded up and deported. Immigration agents are showing up at Home Depots and inside courtrooms, in search of people in the U.S. without authorization. Increasingly, immigrants who are detained are being whisked away and deported to their home countries — or, in some cases, nations where they have no ties — without time for packing or family goodbyes. The Trump administration in January rescinded a policy that once shielded sensitive locations such as hospitals, churches and schools from immigration-related arrests. In response to the survey results, St. John's launched the Health Care Without Fear program in an effort to reach patients who are afraid to leave their homes. Jim Mangia, chief executive and president of St. John's, said in a statement that healthcare providers should implement policies to ensure all patients, regardless of immigration status, have access to care. '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, said one woman reported not having left her home in three months. She said she knows of other patients with chronic conditions who aren't leaving their house to exercise, which could exacerbate their illness. Even some immigrants in the U.S. legally are expressing reservations, given news stories about the government accusing people of crimes and deporting them without due process. Olusanya said waiting for people to come back in for medical care on their own felt like too great a risk, given how quickly their conditions could deteriorate. '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?' On a recent Thursday at St. John's Avalon Clinic in South L.A., Olusanya prepared to head to the home of a patient who lived about 30 minutes away. The Avalon Clinic serves a large population of homeless patients and has a street team that frequently uses a van filled with medical equipment. The van is proving useful for home visits. Olusanya spent about 30 minutes preparing for the 3 p.m. appointment, assembling equipment to draw blood, collect a urine sample and check the patient's vitals and glucose levels. She said she has conducted physical exams in bedrooms and living rooms, depending on the patient's housing situation and privacy. She recalled a similar drop in patient visits during Trump's first administration when he also vowed mass deportations. Back then, she said, the staff at St. John's held drills to prepare for potential federal raids, linking arms in a human chain to block the clinic entrance. But this time around, she said, the fear is more palpable. 'You feel it; it's very thick,' she said. While telehealth is an option for some patients, many need in-person care. St. John's sends a team of three or four staff members to make the house calls, she said, and are generally welcomed with a mix of relief and gratitude that makes it worthwhile. '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.'
Yahoo
24-04-2025
- Health
- Yahoo
Fight or flight? Some California nonprofits won't remain silent in face of Trump budget slashing
With the Trump administration slashing budgets and threatening to revoke tax-exempt status for nonprofits, some Southern California social justice organizations have gone into a defensive crouch, hoping to wait out the passing storm. They are not openly fighting President Trump's program cuts. Some have scrubbed their websites of terms such as 'equity,' 'inclusion' and 'transgender.' Others have been told they should drop land acknowledgments — proclamations paying tribute to the Indigenous peoples who were this region's first human inhabitants. But other local nonprofits intend to fight. They have slammed Trump's policies. They declined suggestions to alter their mission statements. They have gone to court. And one, giant St. John's Community Health — which has provided care for the region's working class and immigrants for 60 years — is launching a campaign to call out congressional Republicans it believes are enabling Trump budget cuts that they believe will cripple healthcare for the poor. The venerable system of health clinics, based in South Los Angeles, on Thursday joined about 10 other nonprofits in launching a media campaign that will focus on half a dozen U.S. House districts where Republican lawmakers have supported the president's initial budget plan. Read more: If Trump cuts Medicaid, this California Republican's House seat would be imperiled The campaign by the newly created Health Justice Action Fund will promote the theme "Medicaid matters to me." The organization plans to spend $2 million in the coming weeks to focus petitions, phone banks, social media and radio ads on six GOP lawmakers across the country, telling them that their constituents do not support cuts to the principal federal health program for the poor and disabled. The Republican-controlled House and Senate have approved a Trump budget framework that calls for $880 billion in cuts over 10 years from operations overseen by the House Energy and Commerce Committee. Trump and other Republicans insist Medicaid won't have to be cut. But the nonpartisan Congressional Budget Office disagrees, saying the desired savings can be achieved only by slashing Medicaid. The new campaign to head off those cuts has been organized by Los Angeles-based St. John's Health and its president and chief executive, Jim Mangia. 'The Medicaid cuts being proposed by Republicans and President Trump would be devastating to the health of low-income families throughout the United States,' Mangia, who has led St. John's for a quarter of a century, said in an interview. 'There are tens of millions of people who depend on Medicaid and, in California, Medi-Cal, for their basic healthcare. To cut that to fund tax breaks for billionaires is a perversion of what this country is supposed to be about.' Mangia and his board of directors said they understand that their sprawling healthcare organization, with more than 20 locations in Southern California, could be targeted for calling out the president and his budget. 'Our posture is to fight,' Mangia said. 'A lot of community health centers have been scraping their websites and taking words like 'trans' and 'African American' off their websites. We're not going to do that. We are not going to erase the people we serve.' Leaders of nonprofits that serve the poor, immigrants and the LGBTQ+ community have been engaged in intense conversations for weeks about how to respond to Trump and his policies, which explicitly aim to curtail services to some of those populations. When Trump said last week that he might begin trying to revoke the nonprofit status of some groups, anxiety among the agencies spiraled to a new high, said Geoff Green, chief executive of CalNonprofits, which represents thousands of organizations with tax-exempt status. 'There have been financial stresses and budget cuts before,' Green said. 'But now it's not only financial stress, it's direct targeting of their very existence and challenges to the values that are at the core of a lot of their work.' Leaders of smaller organizations, in particular, don't feel they have the power or money to take the Trump administration to court. Others, representing immigrants, worry that their leaders or their clients could be targeted for deportation if they protest publicly. 'For some people in this community this is like a kind of code-switching,' said an executive at one social justice nonprofit, who declined to be named. 'They might change some terms on their websites, but it's not going to change their mission. They want to avoid conflict or attacks, so they can come out the other end of this and do the good work.' In one instance, a nonprofit declined to receive an award sponsored by a member of the California Legislature, because the organization worried the award would bring unwanted attention to its service to immigrants. 'At the end of the day, it's about protecting the most vulnerable of us,' said the social justice executive. 'Some organizations have more privilege, they have more resources. They can afford to go to court. They can be more bold.' Public Counsel is among the public interest law firms whose contracts the Trump administration has threatened with termination. The potential loss of $1.6 million puts in jeopardy the Los Angeles-based firm's representation of hundreds of immigrant children, unaccompanied minors who often have no adult support. Public Counsel Chief Executive Kathryn Eidmann said she believes her organization has a duty to call out what it sees as an injustice: leaving vulnerable children without legal representation. 'We have a responsibility to stand up for our mission and to stand up for our clients and the rule of law,' Eidmann said. Public Counsel is seeking to intervene in court on behalf of "sanctuary" cities such as Los Angeles, which have been threatened with a loss of federal funding, and the firm has come to the defense of law firms targeted for providing pro bono representation to groups out of favor with the Trump administration. Public Counsel and other nonprofit law firms continue to wait to see whether the Trump administration will honor a judge's temporary restraining order, requiring that funds continue to flow to those representing immigrant children. As of Wednesday, the funding had not been restored, a Public Counsel spokesperson said. Another L.A.-area nonprofit threatened with the loss of federal funding under Trump's anti-DEI push is the Los Angeles Neighborhood Land Trust. The group had won a $500,000 grant from the Environmental Protection Agency to help ensure that redevelopment along the Los Angeles River in northeast L.A. protects housing, jobs and services for working-class families. But the money stopped flowing this year, without any explanation from the EPA, said Tori Kjer, executive director of the land trust. 'To them, this is probably a waste of money,' Kjer said. 'To us, it's about equitable development and building in a way that supports everyone.' Kjer said a staffer for a liberal House member urged her group to take a low profile and to, for example, delete the Indigenous land acknowledgments that are in the signature line of all its emails. She declined to do that. 'We are not going to change our ways because of Trump,' Kjer said. 'In California, as a state and in this region, we are still very progressive. If we can't keep this kind of work going here, we are in real trouble. We feel we need to resist, if even in a small way.' The campaign to protest potential Medicaid cuts will focus on six House districts where use of the federally funded health system is high and where Republicans hold, at best, a narrow electoral advantage. Read more: With Head Start in jeopardy, Trump administration threatens child care for 800,000 kids The targeted districts include David Valadao's in the Central Valley and Ken Calvert's in the Coachella Valley. Nearly two-thirds of Valadao's constituents use Medicaid, while about 30% in Calvert's district do so. Residents in those districts will hear how the Trump budget plan threatens to cut Medicaid for 'everyday people,' and how substantial reductions could threaten to shutter rural hospitals that are already struggling to make ends meet. The Health Justice Action Fund was created as a 501(c)(4) by St. John's and about 10 other healthcare providers, who have chosen to remain anonymous. The regulations governing such funds allow them (unlike the nonprofits themselves) to engage in unlimited lobbying and some political activity. The rules also allow contributors to remain anonymous, which Mangia said is necessary for some of his partners, who believe they will be targeted for retaliation if it becomes clear they tried to thwart Trump's policies. House Republicans who have been pressed about their position have contended, despite a contrary view from experts, that the Trump cuts can be executed without taking services from Medicaid recipients. Valadao was among a dozen House Republicans who sent a letter to party leaders saying they would not support the White House's plan if it will force cuts to Medicaid. Republican leaders have assured their wobbling colleagues that they intend to root out waste, fraud and abuse only, not cut Medicaid benefits. Mangia said the campaign he and his allies are waging should make it extra clear to the House Republicans that Medicaid can't be cut. 'There is a very scary environment right now,' Mangia said. 'But someone had to step up and defend Medicaid and the basic healthcare it provides for so many people. We weren't going to let this happen without a fight.' Get the L.A. Times Politics newsletter. Deeply reported insights into legislation, politics and policy from Sacramento, Washington and beyond, in your inbox twice per week. This story originally appeared in Los Angeles Times.
Los Angeles Times
24-04-2025
- Health
- Los Angeles Times
Fight or flight? Some California nonprofits won't remain silent in face of Trump budget slashing
With the Trump administration slashing budgets and threatening to revoke tax-exempt status for nonprofits, some Southern California social justice organizations have gone into a defensive crouch, hoping to wait out the passing storm. They are not openly fighting President Trump's program cuts. Some have scrubbed their websites of terms such as 'equity,' 'inclusion' and 'transgender.' Others have been told they should drop land acknowledgments — proclamations paying tribute to the Indigenous peoples who were this region's first human inhabitants. But other local nonprofits intend to fight. They have slammed Trump's policies. They declined suggestions to alter their mission statements. They have gone to court. And one, giant St. John's Community Health — which has provided care for the region's working class and immigrants for 60 years — is launching a campaign to call out congressional Republicans it believes are enabling Trump budget cuts that they believe will cripple healthcare for the poor. The venerable system of health clinics, based in South Los Angeles, on Thursday joined about 10 other nonprofits in launching a media campaign that will focus on half a dozen U.S. House districts where Republican lawmakers have supported the president's initial budget plan. The campaign by the newly created Health Justice Action Fund will promote the theme 'Medicaid matters to me.' The organization plans to spend $2 million in the coming weeks to focus petitions, phone banks, social media and radio ads on six GOP lawmakers across the country, telling them that their constituents do not support cuts to the principal federal health program for the poor and disabled. The Republican-controlled House and Senate have approved a Trump budget framework that calls for $880 billion in cuts over 10 years from operations overseen by the House Energy and Commerce Committee. Trump and other Republicans insist Medicaid won't have to be cut. But the nonpartisan Congressional Budget Office disagrees, saying the desired savings can be achieved only by slashing Medicaid. The new campaign to head off those cuts has been organized by Los Angeles-based St. John's Health and its president and chief executive, Jim Mangia. 'The Medicaid cuts being proposed by Republicans and President Trump would be devastating to the health of low-income families throughout the United States,' Mangia, who has led St. John's for a quarter of a century, said in an interview. 'There are tens of millions of people who depend on Medicaid and, in California, Medi-Cal, for their basic healthcare. To cut that to fund tax breaks for billionaires is a perversion of what this country is supposed to be about.' Mangia and his board of directors said they understand that their sprawling healthcare organization, with more than 20 locations in Southern California, could be targeted for calling out the president and his budget. 'Our posture is to fight,' Mangia said. 'A lot of community health centers have been scraping their websites and taking words like 'trans' and 'African American' off their websites. We're not going to do that. We are not going to erase the people we serve.' Leaders of nonprofits that serve the poor, immigrants and the LGBTQ+ community have been engaged in intense conversations for weeks about how to respond to Trump and his policies, which explicitly aim to curtail services to some of those populations. When Trump said last week that he might begin trying to revoke the nonprofit status of some groups, anxiety among the agencies spiraled to a new high, said Geoff Green, chief executive of CalNonprofits, which represents thousands of organizations with tax-exempt status. 'There have been financial stresses and budget cuts before,' Green said. 'But now it's not only financial stress, it's direct targeting of their very existence and challenges to the values that are at the core of a lot of their work.' Leaders of smaller organizations, in particular, don't feel they have the power or money to take the Trump administration to court. Others, representing immigrants, worry that their leaders or their clients could be targeted for deportation if they protest publicly. 'For some people in this community this is like a kind of code-switching,' said an executive at one social justice nonprofit, who declined to be named. 'They might change some terms on their websites, but it's not going to change their mission. They want to avoid conflict or attacks, so they can come out the other end of this and do the good work.' In one instance, a nonprofit declined to receive an award sponsored by a member of the California Legislature, because the organization worried the award would bring unwanted attention to its service to immigrants. 'At the end of the day, it's about protecting the most vulnerable of us,' said the social justice executive. 'Some organizations have more privilege, they have more resources. They can afford to go to court. They can be more bold.' Public Counsel is among the public interest law firms whose contracts the Trump administration has threatened with termination. The potential loss of $1.6 million puts in jeopardy the Los Angeles-based firm's representation of hundreds of immigrant children, unaccompanied minors who often have no adult support. Public Counsel Chief Executive Kathryn Eidmann said she believes her organization has a duty to call out what it sees as an injustice: leaving vulnerable children without legal representation. 'We have a responsibility to stand up for our mission and to stand up for our clients and the rule of law,' Eidmann said. Public Counsel is seeking to intervene in court on behalf of 'sanctuary' cities such as Los Angeles, which have been threatened with a loss of federal funding, and the firm has come to the defense of law firms targeted for providing pro bono representation to groups out of favor with the Trump administration. Public Counsel and other nonprofit law firms continue to wait to see whether the Trump administration will honor a judge's temporary restraining order, requiring that funds continue to flow to those representing immigrant children. As of Wednesday, the funding had not been restored, a Public Counsel spokesperson said. Another L.A.-area nonprofit threatened with the loss of federal funding under Trump's anti-DEI push is the Los Angeles Neighborhood Land Trust. The group had won a $500,000 grant from the Environmental Protection Agency to help ensure that redevelopment along the Los Angeles River in northeast L.A. protects housing, jobs and services for working-class families. But the money stopped flowing this year, without any explanation from the EPA, said Tori Kjer, executive director of the land trust. 'To them, this is probably a waste of money,' Kjer said. 'To us, it's about equitable development and building in a way that supports everyone.' Kjer said a staffer for a liberal House member urged her group to take a low profile and to, for example, delete the Indigenous land acknowledgments that are in the signature line of all its emails. She declined to do that. 'We are not going to change our ways because of Trump,' Kjer said. 'In California, as a state and in this region, we are still very progressive. If we can't keep this kind of work going here, we are in real trouble. We feel we need to resist, if even in a small way.' The campaign to protest potential Medicaid cuts will focus on six House districts where use of the federally funded health system is high and where Republicans hold, at best, a narrow electoral advantage. The targeted districts include David Valadao's in the Central Valley and Ken Calvert's in the Coachella Valley. Nearly two-thirds of Valadao's constituents use Medicaid, while about 30% in Calvert's district do so. Residents in those districts will hear how the Trump budget plan threatens to cut Medicaid for 'everyday people,' and how substantial reductions could threaten to shutter rural hospitals that are already struggling to make ends meet. The Health Justice Action Fund was created as a 501(c)(4) by St. John's and about 10 other healthcare providers, who have chosen to remain anonymous. The regulations governing such funds allow them (unlike the nonprofits themselves) to engage in unlimited lobbying and some political activity. The rules also allow contributors to remain anonymous, which Mangia said is necessary for some of his partners, who believe they will be targeted for retaliation if it becomes clear they tried to thwart Trump's policies. House Republicans who have been pressed about their position have contended, despite a contrary view from experts, that the Trump cuts can be executed without taking services from Medicaid recipients. Valadao was among a dozen House Republicans who sent a letter to party leaders saying they would not support the White House's plan if it will force cuts to Medicaid. Republican leaders have assured their wobbling colleagues that they intend to root out waste, fraud and abuse only, not cut Medicaid benefits. Mangia said the campaign he and his allies are waging should make it extra clear to the House Republicans that Medicaid can't be cut. 'There is a very scary environment right now,' Mangia said. 'But someone had to step up and defend Medicaid and the basic healthcare it provides for so many people. We weren't going to let this happen without a fight.'
Associated Press
04-02-2025
- Health
- Associated Press
LA clinics lose funding for transgender health care as Trump executive orders take hold
A Los Angeles health clinic says it's losing federal funding as a result of President Donald Trump 's executive orders targeting transgender people. St. John's Community Health, one of the largest free and reduced-cost providers in Los Angeles, reported that the Centers for Disease Control and Prevention on Friday terminated a $1.6 million grant that was supposed to support its transgender health and social services program. St. John's is the first California health provider to publicly report service impacts as a result of the Trump administration's actions. According to a letter from the CDC, the grant was ended in order to comply with an executive order requiring federal agencies to only recognize two genders. 'At St. John's we believe everyone has a fundamental human right to health care. You can disagree with quote-on-quote gender ideology and how people may choose to live their lives, but that doesn't give you the right to strip away their access to health care,' said Jim Mangia, president and chief executive of St. John's Community Health. The grant, which started in 2022, was funded through the CDC's HIV prevention program. It allowed St. John's to operate a program for transgender adults that included sexually transmitted infection and HIV testing, health education and connections to social services including housing, substance use treatment and food stamps, Mangia said. More than 500 people received services through the grant annually. Last week, along with thousands of clinics across the country, St. John's experienced a brief suspension in its access to more than $18 million of federal funding as a result of a separate executive order and internal budget memo that attempted to broadly freeze federal aid. Two separate judges have blocked that order temporarily, but those decisions don't apply to the executive order now preventing St. John's from accessing its grant money for transgender patients, Mangia said. St. John's will not cut services and is prepared to sue over the continued withholding of federal money, he added. 'We believe these grants were allocated by Congress and are constitutionally protected. We will pursue every avenue available to us to keep these programs funded,' Mangia said. Several of Trump's executive orders in the past two weeks have targeted transgender people, including attempts to bar them from military service and prevent schools from recognizing pronouns or when a student transitions. Last week, Trump issued another executive order barring federal funding for transgender health services for minors, including hormone therapy and surgical procedures. The order specifically called out federal research grants given to hospitals and medical schools as well as Medicare and Medicaid funding. In that order and others, Trump describes gender-affirming care as 'sterilizing,' 'mutilation' and 'maiming,' characterizations that are in direct opposition to clinical evidence supported by major medical organizations including the American Medical Association, American Academy of Pediatrics and the American College of Obstetricians and Gynecologists, all of which oppose government interference in doctor-patient decisions. Already hospitals across the country are stopping gender-affirming services for young people, according to news reports, including major hospitals in New York, Denver and Washington, D.C., which Trump praised in a statement as his 'intended effect.' Organizations across the state that provide health and social services to transgender people are worried about their funding, said Jorge Reyes Salinas, communications director for Equality California, the state's largest LGBTQ and civil right's advocacy group. 'These actions by the Trump administration could deny trans people the right to medically necessary care and put their housing and employment at risk — deepening pre-existing health and economic disparities and fueling further discrimination,' Salinas said in a statement. At least 24 organizations in California have received federal funding over the past five years for transgender health programs or research, according to federal data on grants distributed by the CDC and National Institutes of Health. California's LGBTQ groups and top Democratic officials were quick to condemn the moves last week and assure state residents that California laws protecting transgender rights and services remain in place. 'California families seeking gender affirming care, and the doctors and staff who provide it, are protected under state laws like the Transgender, Gender Diverse, and Intersex (TGI) Inclusive Care Act. The President's order does not change that,' Attorney General Rob Bonta said in a statement. State law requires state-regulated insurers to cover medically necessary gender-affirming care, including mental health services. It provides license protections for doctors who treat transgender patients, and includes broad nondiscrimination protections. Still, Trump's orders have sown confusion among providers who are hesitant to run afoul of the law or lose vital money. 'Some medical providers are starting to preemptively cancel appointments with transgender youth because they're afraid of losing their license or funding,' said Dannie Ceseña, director of the California LGBTQ Health & Human Services Network. 'I'm hearing it across the state from a variety of partners.' Ceseña said any such cancellations are 'inconsistent with California law' and families should contact the attorney general's office if they experience them. ___
