Long Island immigrants avoid health care amid ICE fears, groups say

Some Long Island immigrants are not showing up for medical or mental health appointments or are  shifting to telehealth after the Trump administration rescinded a policy that had generally barred immigration enforcement at or near health facilities, health care and immigrant groups say.

In-person visits at some locations of Harmony Healthcare, the largest group of nonprofit health centers in Nassau County, with tens of thousands of patients, have fallen 10% to 15%. At Hispanic Counseling Center sites in Hempstead and Bay Shore, 25% to 30% more clients are requesting telehealth instead of in-person appointments. That puts their clients' physical and mental health at risk, leaders of those organizations said.

Immigration and Customs Enforcement in a statement Friday said there had not been any enforcement at Long Island health clinics or centers and that it doesn't typically target those facilities.

Yet fear is widespread, said Melanie Creps, executive director of the Central American Refugee Center, known as CARECEN, a group with offices in Brentwood and Hempstead that serves immigrants from any country. People in the country without legal authorization are worried they could get picked up by ICE agents at or near health centers, but even some immigrants in the country legally are concerned they’ll get caught up in the Trump administration's enforcement push, Creps said.

"They don’t know where they [ICE] are going to show up and what kind of information they have and who they’re going to grab," Creps said. "They’re afraid to go anywhere in public."

The easing of restrictions on immigration agents' visits to health care facilities came amid President Donald Trump's vow to deport millions of people who are in the country illegally.

A Department of Homeland Security directive issued shortly after Trump's inauguration repealed a Biden administration policy of avoiding enforcement at or near "protected areas" like health centers, hospitals, schools and houses of worship.

But ICE said in a statement Wednesday it "conducts targeted enforcement operations focusing on criminal aliens and public safety threats" and "does not typically conduct immigration enforcement activities at medical facilities, schools or school buses. Such law enforcement actions are conducted only when warranted by exigent circumstances and approved by a supervisory law enforcement official."

Even so, ICE said in a later statement it "will be using the 'common sense' standard for any enforcement actions at these locations, relying on the discretion of the law enforcement officer." The agency emphasized "all aliens in violation of U.S. immigration law may be subject to arrest, detention and, if found removable by final order, removal from the United States."

One Long Island health care institution that serves many immigrants, the public Nassau University Medical Center in East Meadow, said in an email "there is no evidence of avoidance" by immigrants seeking care. Several other health care centers did not respond to queries or declined to comment.

After the DHS directive received extensive media attention, word spread among immigrants that ICE could now target health centers, said Olga El Sehamy, founder and executive director of Mosaico, which connects Suffolk County residents, primarily immigrants, with services.

"They’ve heard those are no longer safe spaces," she said.

"People ask me should I cancel my doctor’s appointment," said El Sehamy, a former Suffolk assistant deputy county executive. "I say ‘No, go to the doctor.’"

She tells clients the likelihood of an ICE raid at a health center is low, but she gives them cards that advise them of their rights.

Immigrants' avoidance of the organization's mental health and substance use disorder services leads to less effective treatment, said Claudia Boyle, CEO of Hispanic Counseling Center, which serves 1,900 clients a month.

"We always prefer the clients to come in person," because someone’s body language and other nonverbal cues can offer insights into how someone truly is feeling, she said.

"But because some of the clients are afraid, and they're fearful that they might be targeted, or that something might happen even on the way here, clients are requesting to either switch to remote or are canceling their appointments" or not showing up, she said.

Boyle said clients and staff in the country legally are worried that "because of just the way they look, they might be stopped on the street regardless of status" — and that their legal status could be reversed under Trump.

At Harmony, which runs nine nonprofit health centers in Nassau, "patients have told us they’re very, very scared," said David Nemiroff, president and CEO of the organization, which serves nearly 49,000 people a year. Widespread fear is causing Harmony patients to miss appointments or switch to telehealth, which is not appropriate for some types of medical visits, he said.

Harmony does not ask patients' immigration status, and Nemiroff said the health centers will continue to serve anyone who has no other option for care, including uninsured people. A 2023 nationwide survey found half of immigrants in the country illegally lacked health insurance, and many seek medical care at nonprofit centers like Harmony, because most do not qualify for nonemergency government-funded health care from programs like Medicaid or Medicare.

"We’re going to take care of folks, because we’ll take care of anybody, regardless of their ability to pay," Nemiroff said.

Harmony has an immigration-enforcement policy similar to other health care organizations, such as Stony Brook Medicine, as well as CARECEN: ICE agents and others enforcing immigration law must present a warrant signed by a judge or magistrate before being allowed entry.

Ten Nassau County detectives work with ICE to arrest and deport immigrants accused of a crime, in a collaboration announced Feb. 4. But Nassau Police Lt. Scott Skrynecki said "when we work with ICE, it’s targeted. We’re looking for a specific individual" and not conducting identification checks.

That echoes what County Executive Bruce Blakeman said Feb. 14, when he said there would not be raids at health care facilities like hospitals, and that "we’re not going after people who are law-abiding."

Nemiroff said health centers like his are critical to keeping people with few or no other low-cost medical options healthy. If immigrants avoid routine checkups and early treatment, they may end up getting more seriously ill, he said.

Federal law still requires that almost all hospitals treat anyone in an emergency, whether they have insurance or not.

"If people don’t get preventive care and are just going to the emergency room for end-stage diseases, it will be much more expensive and we all wind up paying for that at the end of the day," Nemiroff said. "It’s a lose-lose situation."

By David Olson

david.olson@newsday.com@DavidOlson11

David Olson covers health care. He has worked at Newsday since 2015 and previously covered immigration, multicultural issues and religion at The Press-Enterprise in Southern California.