The Desert Healthcare District (DHCD) planned to hold a women’s wellness event last December in North Shore, a predominantly Latino community of about 3,500 at the northern edge of the Salton Sea.
But when the community engagement team began calling around to confirm appointments, patients started canceling. Reports of Immigration and Customs Enforcement raids were circulating on social media, while some shared accounts of friends or family members being detained.
“As we were calling them, they were letting us know, ‘No, I don’t want to go, because my partner is undocumented, and they’re my primary means of transportation,’” said Alejandro Espinoza, DHCD’s chief of community engagement. “Women who were undocumented didn’t outright say that they were undocumented, but we know our community, and we saw a lot of people cancel for that event.”
DHCD ultimately canceled the clinic and rescheduled it for February. The episode is just one example of the ways in which the threat of ICE raids under the Trump administration has rippled through health-care systems across Southern California.
In the Coachella Valley, providers in immigrant communities report that fewer patients are seeking care since new ICE enforcement policies took hold last year. Organizations hosting health-care events in farmworker communities saw attendance drop in 2025 when local ICE activity increased. DHCD alone saw a 25% decrease in mobile health care visits.
Looking ahead, changes to California’s Medi-Cal program are expected to further limit access. As of this year, the state is no longer providing new, full-scale Medi-Cal enrollment for some adults who are undocumented. Beginning in July 2027, some enrollees will have to pay monthly premiums to keep benefits.
In response, providers are rethinking how to deliver care to people who are undocumented. Mobile clinics are showing up at private, undisclosed locations instead of public events. Community health-care workers are conducting training and public meetings on Zoom. And there’s new funding being directed toward clinics and services in the eastern Coachella Valley to serve migrant communities.
Espinoza said one of the first priorities for his team is making sure the community knows that health-care providers don’t share information with immigration officials.
“A big part of it is awareness, and ensuring we’re developing culturally sensitive messaging in traditional and non-traditional ways to ensure that our community members who are seeking these resources know where to go,” Espinoza said.
Finding New Ways to Serve a Vulnerable Population
According to the California Immigrant Data Portal, a project of USC’s Equity Research Institute, about 2.8 million undocumented immigrants lived in the state in 2023. In the eastern and central parts of Riverside County, immigrants make up about 24% of the population. Around 74,900 of those residents are undocumented or living in households with mixed status.
But this population is longstanding: About 74% of those who are undocumented have been here for 10 years or more, and 44% have been here for at least 21 years. Across California, these communities have endured numerous traumatic and high-impact raids targeting this community—including one at a St. John’s Community Clinic street medicine event in Los Angeles last summer.
While city-specific ICE takeovers like those in Minneapolis have faded from headlines, locals in the Coachella Valley are still spotting Border Patrol vehicles in places like Home Depot parking lots, or along Interstate 10.
When local ICE sightings started increasing, Espinoza said his DHCD team started coordinating with private-property owners to find places to bring its mobile health-care units, like churches, agricultural fields and packing houses. The main goal, he said, was to get people the health care they needed in places ICE couldn’t legally enter. Health-care providers are under no legal obligation to tell federal immigration enforcement officials anything about the status of their patients—but immigration agents may enter public areas of a health-care facility without a warrant or the facility’s consent.
But these mobile clinics on private property still required people to take a risk by leaving their homes.
“The challenge was still there, because how do the community members get there?” Espinoza said. “There were still issues where there might be a checkpoint leading up to that church or that field or that distribution center where ICE might have set up.”
Melinda Cordero-Barzaga is a co-founder of Vision y Compromiso, a 26-year-old organization that trains and supports promotoras, a predominantly Latina women-led workforce of community health workers. In the Coachella Valley, the workforce is active in farmworker communities. At one point last year, one of their promotoras quit due to a fear of exposure around ICE raids, Conrado-Barzaga said.
“She was so scared that she actually quit her job with us, because she did not want to leave her home,” Cordero-Barzaga said. “She has three children and wanted to just be home with them and ensure that she did just not run any risks, because it’s only her and her husband living here.”
Cordero-Barzaga, like Espinoza, said the threat of ICE raids have caused a decrease in larger health-care events, and they’ve been replaced, in part, by more discreet forms of aid, like virtual visits and meetings in largely undisclosed locations.
“There’s still this fear in the community, and people are having this hypervigilance about the situation,” Cordero-Barzaga said.
Vision y Compromiso began holding monthly Zoom trainings in English and Spanish on how to respond to potential ICE encounters—and, at the request of promotoras, started mental-health support programs.
“This really came from asking promotoras, ‘What do you need right now?’ And (ICE rights training) was one. And the second was, ‘We need a space to talk about mental health, because we are on the front line, and we need to process some of the things that we’re dealing with.’”
Planning for Future Needs
The challenges are forcing providers to think differently about how they deliver care in the short-term—and the long-term as well.
Anthony White is the vice president of government and community affairs at TrueCare, a federally qualified health center that operates across Southern California. He said Medi-Cal enrollment changes will force challenges across the health-care industry, and that TrueCare has already experienced small decreases in weekly visits to clinics from Medi-Cal enrollees this year.
He said the overarching concern is that some patients may forgo care entirely if they lose coverage, or opt out due to new premiums, increasing the risk of people landing in emergency rooms with chronic conditions.
“We’re really trying to educate our patients to understand that even if they do lose their insurance, we’re going to care for them,” White said. “Our mission and our mandate from the federal government is that we care for everybody.”
At DHCD, CEO Chris Christensen said the organization is focused on long-term solutions to increase access to care. In March, it awarded a $2,975,625 grant to Innercare, a federally qualified health center that operates bilingual clinics in Coachella and Mecca. The money is meant to support the development of a Coachella Valley teaching health center program, over the next three years, to address the community’s physician shortage.
The district also gave $185,337 to the Mecca-based nonprofit Galilee Center to continue its Bridge to Health program, which connects underserved and migrant families to medical and behavioral health services.
DHCD is in the midst of a strategic planning process, as access to care becomes more difficult for vulnerable populations, including residents who are undocumented. Potential solutions include ramping up mobile health unit activities, as well as working with organizations like Coachella Valley Volunteers in Medicine, which provides care free of charge, regardless of insurance or immigration status.
“Part of our strategic plan is to develop the partnerships and relationships with other organizations to leverage resources that are available—whether they’re financial or through personnel—that can do outreach and provide some kind of access to the care that people need and deserve,” he said.
To that end, some of the most impactful efforts continue to come from within the most affected communities. Cordero-Barzaga from Vision y Compromiso said the organization’s annual conference last September saw record attendance. The theme was “Building Resistance, Sowing Hope and Harvesting Community Power.”
“This is what, to me, is incredible,” Cordero-Barzaga said. “People may be experiencing this fear for their own family or for themselves as the promotora, and they are still wanting to learn—and they’re not standing still,” she said.
Melissa Daniels reported this story while participating in the USC Annenberg Center for Health Journalism’s 2026 California Health Equity Fellowship.
