SAN JUAN, RGV – Senate Bill 4 does not take effect until September but it is already having an impact on attendances at mobile health clinics in the Rio Grande Valley, say healthcare specialists.

Ciara Ayala, outreach and special projects coordinator for La Unión del Pueblo Entero, said there has been an “alarming” reduction in the number of mothers and children utilizing the group’s “Health on Wheels” program.

As a result, she said, LUPE may have to move the clinics away from community centers and schools and into churches.

“I oversee the “Health on Wheels’ program, which includes mobile clinics. We have a team from across the Valley, from Alton to Brownsville. Their job is to connect the community with access to healthcare. We do that by taking mobile clinics into colonias and low-income neighborhoods, where healthcare need is greatest. We are trying to overcome some basic obstacles like transportation or lack of documentation,” Ayala explained.

“When we started this program last year it was a huge success. We were seeing numbers increase every month, with the number of patients that would come into our clinics. There was a very steady increase until November and December of 2016. That is also the time when we changed presidents. What we have seen, going into 2017, is a decrease in patient turnout at clinics across the Valley.”

So, everyone is getting healthier, they don’t need your help, a reporter asked. “We would hope, but probably not,” Ayala responded.

While attendances at LUPE’s mobile clinics dropped around the time President Trump took office, it deteriorated at a much greater rate in April, Ayala said, when news coverage of Senate Bill 4 heightened. The legislation, deemed a priority by Gov. Greg Abbott, allows local law enforcement to ask the immigration status of residents they stop.

“So, patient turnout has been very low. Then we started noticing around the end of April that it was getting dramatically low. Some clinics were only seeing three patients a day, whereas before we were seeing upwards of 20 patients. This was a very serious concern to us and our program so we started asking around,” Ayala said.

“Overwhelmingly, the response from the community was that people are afraid, plain and simple. There are a lot of anecdotes from people who have experienced this fear. So, for example, there was a clinic at a community center and it got no patients because there is a Border Patrol agent parked right in front of the colonia. So, no one was going to come out.”

Ayala said when low-income families who lack health insurance do not visit LUPE’s mobile clinics, the health of the family deteriorates.

“It is really affecting not only our program but, I am sure, (other healthcare) programs across the Valley. The bigger impact is it is affecting people’s health. Not only are you not accessing healthcare, like a basic doctors’ visit, but living with fear and anxiety is an added burden on you, especially when it comes to your health. People are waking up and wondering, where am I going to be tomorrow. What is going to happen today, what is going to happen to my family. This is a serious issue we are trying to overcome,” Ayala said.

Ayala said that in response to the reduction in attendances, LUPE has moved the location of its mobile clinics.

“We have partnered with a lot of different community organizations. Last year we were working very closely with community centers. What we are finding this year is that our stronger allies are going to be our churches because there is not going to be any ICE or Border Patrol presence. People feel safer going to a religious institution, as opposed to a community center that is run by the city, unfortunately.”

Ayala gave an example.

“We work with Valley Care Clinics. They used to have a regular clinic at the Progreso Community Center. Attendance was getting so low that they had to stop going to that site. What we did is reach out to a church in Progreso and we talked to the pastor there. He expressed some interest so now we are going to move the clinic from the community center into the church. This will start this month. Hopefully we will see a better turnout. We have seen good numbers partnering with the churches in the area.”

Ayala said as more federal are spent on border security, more Border Patrol cars are parked along the side of the road. She said the same is true at the state level. The more funds the Legislature appropriates to border security, the more DPS cars are parked along the side of the road.

“It is pretty uniform throughout the Valley that there is a heavy Border Patrol presence and that there has been an increase in Border Patrol visibility and DPS visibility on the streets. I see that just driving to and from work. When I am doing site visits in Cameron County and in Alton, it is something that I have noticed. I am not the only one noticing it. The people that are afraid for their lives, they are noticing it. It used to be one now and then. Now, you are seeing it every day, wherever you go.”

Asked if mobile clinics could be pulled from school districts across the Rio Grande Valley once SB 4 becomes law, Ayala said:

“That has been brought up. Taking clinics to schools might be an issue because of campus police. Which is terrible, absolutely terrible. It depends on each superintendent. We are waiting to hear back from immigration lawyers on the details of SB 4, so we can address our practices accordingly. We do not want to put our community members in danger or at risk just so they can go get a checkup.”

Asked if she would like to say anything else about LUPE’s “Health on Wheels” program, Ayala said:

“I think a lot of people take it for granted they can see the doctor without any additional worry beyond, what is wrong with me, I am feeling sick. I think that now more than ever we need to start thinking about our neighbors and about how our decisions impact, not only ourselves but the entire community. For us at LUPE, we are always going to be listening to the community, what they have to say and then responding.”

Editor’s Note: Reporter Apolonio Sandoval, Jr., contributed to this story from San Juan, Texas.