Jim García founded Clinica Tepeyac 23 years ago. As a community-based health care center, it provides primary and behavioral health care, and health education to Metro Denver’s medically underserved, predominantly Latino population. Many patients are undocumented. The clinic’s capacity has grown to handle 20,000 patient visits annually. In an interview with Catherine Strode, policy and outreach specialist for Advocacy Denver, García discussed how he separates the issue of health care disparities with politics.
Catherine Strode: What levels of immigration status make patients eligible for treatment?
Jim García: We don’t have any requirements in terms of a person’s immigration status. We ask for their basic information, their income information. There’s nothing we disallow for a person coming to our clinic. There was this opportunity to start up this clinic through Our Lady of Guadalupe church. At the time, we were having this conversation about people in the North Denver community not being able to access health care. Not exclusively because of their immigration status — but for whatever reason they were facing barriers — we wanted to be that clinic they could go to because they had nowhere else to go. We have people who take three or four buses to get here. We have people from the mountain communities that come to get services here. We were very intentional about creating our own system where there wouldn’t be barriers to care. We do our best to keep politics out of the conversation as far as our organization is concerned. If people happen to be undocumented, that’s something we accept. Our focus is what we can do to relieve the suffering and provide that basic service.
CS: What kinds of treatment do you offer?
JG: We’re a full family-practice clinic, so we offer the full spectrum of medical service screenings, screenings for chronic disease. We have a referral relationship with Saint Joseph Hospital, primarily for patients with a condition that’s beyond our scope of care. We have a mix of MDs, and mid-level providers. We also have a group of volunteer physicians. Others are physicians from Kaiser that are part of their Community Benefit program. Our focus on prevention, on healthy living, is a very pragmatic, pro-active approach to health care. For the people we serve, the Latino, predominantly immigrant population, these are individuals who are working two or three jobs, just to provide for their families. A lot of times the whole idea of being proactive about their health care isn’t something they have had the luxury to think about.
CS: How do you answer your political critics?
JG: My initial response goes back to how we got started through a faith-based initiative. You don’t look at a person based on that person’s legal status. You look at that person based on an individual that is experiencing need for themselves, for their children. As a society, especially from a faith-based perspective, providing someone with basic health services is not something we see as extraordinary. These are individuals who are here working, contributing to our society, building our homes, taking care of our children, doing whatever work that immigrants do. From a public health standpoint, you don’t want people who have chronic disease untreated, and unimmunized. You want to make sure everyone that’s here who’s going to school, who’s interacting in our communities, has basic health care, preventative care, so it doesn’t become a public health issue.
CS: What do you think the financial costs are of denying care to undocumented families?
JG: I think from a pure financial cost, when you aren’t providing people with basic medical care, that population is going to gravitate toward the emergency departments of the hospitals where the cost is going to be 10 times more expensive than if they were to get treatment at a safety-net clinic. The fact is, this population of undocumented individuals is here. They’re working. They need medical care. The family needs medical attention. It’s a reality of our society. I think we have an obligation to come up with a solution that’s pro-active and keeps the focus on the individual and the family at the forefront.
CS: What do you see as the personal costs?
JG: What I have seen firsthand is people who are delaying care to the point where their condition becomes much more complicated. We had a girl, 14 years old, that showed up with her parents. She had Type I diabetes and it was very advanced. She was 60 pounds underweight and had developed cataracts in both eyes; she was virtually blind. She couldn’t go to school because of her poor health and vision. We treated her, got her on the right medications, and referred her to an eye specialist who did the cataract surgery. What was most interesting about that case was the parents were undocumented and the assumption was the 14-year-old was also undocumented. We found out she was actually a citizen and could have been able to avail herself of medical care. The fear factor the parents were experiencing caused them to wait, almost to the point where it was too late.
CS: Is this “fear factor” widespread?
JG: I would say it is. People are putting off care for themselves, or for their children, just by virtue of their immigration status. There’s a tremendous amount of misinformation out there. People aren’t sure what they should do or if they bring their son or daughter in for medical care if that is going to compromise their ability to gain status in the future. I think a lot of times, they are not taking full advantage of the services for their children because of the fear.
CS: What drives your passion for this work?
JG: I see on a daily basis people whose lives have been transformed by virtue of the services we provide. I derive a tremendous sense of satisfaction from knowing we have made a difference, and what you can do to help a family stay healthy. That’s something that is a big motivator for me.