A health clinic that is a fixture of the stretch of Pico-Union known as "Little Central America" has declared itself a sanctuary from the recent spate of enforcement sweeps targeting undocumented immigrants.
Administrators for the Clínica Monseñor Oscar A. Romero declared the sanctuary policy to the board after caregivers reported an alarming rise in the number of missed medical appointments since the Immigrant and Customs Enforcement sweeps began in earnest in the area in mid-February. Most of the patients who come to clinic for care were born in El Salvador, Guatemala or Mexico, and an estimated 40 percent of them are undocumented, according to Ana Grande, the organizing director for the clinic.
Legal advocates say no-shows for medical appointments at clinics that treat a high volume of undocumented patients are a phenomenon occurring statewide.
"Most patients are not coming to appointments because they have tremendous fear of what will happen to them if they leave their homes," Grande says.
She says the new sanctuary policy was tested last week during a sweep ICE conducted near the clinic: "We had a few community members walk into the clinic and ask if they could stay there for a while."
It remains ICE policy to direct agents to avoid conducting enforcement activities at schools, hospitals, places of worship and public ceremonies or demonstrations, according to ICE senior spokeswoman Virginia Kice. Typically, ICE only will target a health care facility or other such sensitive location under exigent circumstances or with prior approval from a supervisory official.
ICE has ramped up enforcement operations in L.A. in recent weeks, reflecting an aggressive shift in enforcement policy under the Trump administration. Last month, the Department of Homeland Security issued new immigration enforcement guidelines that call for hiring 10,000 additional enforcement agents, increasing the holding capacity at detention centers and reactivating a program that deputizes local law enforcement to help make immigration arrests.
Immigrant rights advocates in L.A. hailed the clinic's decision, saying it is the first of its kind in California. "The move sends a powerful message that immigrants and their families are not alone," says Jorge-Mario Cabrera, communications director for the Coalition for Humane Immigrant Rights Reform.
The clinic's board passed the sanctuary policy at a time when the California Senate is preparing to vote on a bill that would prohibit local and state agencies from using state resources to communicate with federal agents, with a few exceptions — such as task forces involving federal and local agencies. That proposal, the California Values Act, introduced by Senate President Pro Tem Kevin de León, instructs the attorney general to limit assistance with immigration enforcement at a list of sensitive locations, including health clinics.
Grande says the passage of the law is taking longer than expected, prompting the clinic directors to be proactive. "Being a sanctuary just means we are taking those measures to be as protective as possible," she says.
The new procedure dictates that in the event of a visit from ICE, staff is to immediately shut down the clinic and move patients from the reception area into areas restricted to staff. One staff member will be appointed the spokesperson to verify whether ICE has an order for a specific person. Should ICE have a warrant for an individual in the clinic, clinic staff will arrange for legal representation.
"We're not going to hand them off alone," Grande says. "We're going to give them legal representation as well as provide for the safety of the rest of the patients.
"If agents come in storming, our providers are prepared to act as human shields."
As for access to patients' private information, it is already prohibited under state and federal law.
There is some concern among health clinics that if they declare themselves sanctuary spaces it will risk their access to federal funding. President Trump and members of his administration have repeatedly threatened to withhold federal funding from cities and other jurisdictions that place limits on their cooperation with federal enforcement actions. A Jan. 25 White House executive order states that local sanctuary ordinances have "caused immeasurable harm to the American people and to the very fabric of our Republic."
Gabrielle Lessard, a senior policy attorney with the National Immigration Law Center, endorses the policy and says the Romero Clinic is completely within its rights to declare itself a sanctuary. "They're a private nonprofit, so they're not under any obligation to participate in immigration enforcement unless there's a court-ordered warrant where they would be legally required to participate," she says.
"They're sending a message to the community," she continues. "Theres a lot of fear in the community right now because of increased enforcement. We're hearing generally that people have been canceling appointments at healthcare facilities or asking their Medi-Cal enrollment be dropped. So even if the Values Act does go into effect, they're making a declaration to members of the community that this is a safe place to go and they should get the healthcare they need."
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Founded in 1983 by civil-war refugees from El Salvador, the Clínica Romero operates at two locations in L.A., in the Latin American enclaves of Pico-Union and Boyle Heights. It provides a variety of patient services, including internal medicine, dentistry, optometry, mental health and substance abuse counseling.
Since its humble beginnings as an all-volunteer organization, the clinic has been actively engaged in community organizing around immigrant affairs and issues affecting patients — the social determinants of health, as Grande calls them.
Grande says the clinic is urging community health centers statewide to follow suit. She says they're willing to train other clinics and staff to protect their undocumented patients.
"They're looking at us to provide a safe haven where they can go and not be afraid of seeking refuge," she says. "That's why it's important."