In recent years, Immigration and Customs Enforcement (ICE) has taken various enforcement actions across different industries, raising concerns about its potential presence in healthcare facilities. While ICE has historically conducted minimal enforcement in hospitals, a policy that previously limited its activities at “sensitive locations” was rescinded in January 2025. As hospitals prepare for potential interactions with ICE, it is crucial to understand enforcement policies, best practices, and patient rights.
Who Enforces Immigration Law?
The primary agency responsible for immigration enforcement is ICE, a division of the U.S. Department of Homeland Security (DHS). ICE conducts enforcement actions in various industries, particularly those employing undocumented workers. This includes worksite enforcement, I-9 audits, and arrests of unauthorized workers. However, ICE’s involvement in hospitals primarily relates to arrests, access to patient information (including protected health information), and employment audits. ICE’s activities in hospitals are largely focused on patients rather than hospital employees. However, hospitals must be prepared for both scenarios.
Best Practices for Hospitals Dealing with ICE
To protect patient rights and ensure compliance with legal requirements, hospitals should establish clear protocols for handling interactions with ICE.
- Designating a Hospital Liaison, ideally someone with in-house counsel or a senior administrator with legal access. All staff should have access to the liaison’s contact information. Only the hospital liaison should provide information or access
- Knowing Public vs. Non-Public Areas is important because public areas, such as lobbies and waiting rooms can be accessed by ICE, while non-public areas such as treatment rooms, inpatient units, and offices require a judicial warrant to entry.
- When Responding to an ICE visit, only the hospital liaison should provide information or access. The liaison should request identification and a business card from the ICE agent and escort the agent to a private location to further discuss their request. liaison should also request copies of any legal documents that ICE requests.
Do Hospitals have to Cooperate with ICE?
If the officers have a judicial warrant, or a judicial subpoena, there must be compliance. However, a judicial subpoena can still be challenged in court. Administrative warrants (signed by an ICE agent, not a judge) does not require any compliance. Administrative subpoenas also do not require compliance, and if the ICE agents lack any of the proper legal documentation, the hospital can refuse access and requests.
Handling Patient Information Requests from ICE
HIPAA permits but does not require hospitals to disclose patient information to law enforcement. State laws may even further restrict disclosure. Protected health information includes patient name, date of birth, immigration status, admission/discharge details, and treatment records.
If ICE verbally requests protected health information, hospitals are not required to disclose it. Written requests must meet legal standards, but hospitals can still decline or challenge them. If the request involves an imminent threat or national security, the hospital may choose to comply within legal limits.
There are also special considerations in relation to reproductive health data. 2024 amendment prohibits hospitals from sharing reproductive health information for prosecution process. Hospitals must obtain a written attestation before disclosing protected health information relating to reproductive care. Legal challenges to this amendment are ongoing as of January 2025.
Final Thoughts
While ICE historically conducted minimal enforcement in hospitals, the rescission of the “sensitive locations” policy in 2025 means healthcare facilities should be prepared for potential encounters. By understanding legal rights, patient protections, and enforcement procedures, hospitals can ensure they comply with laws while safeguarding patient privacy.
If you work in a hospital, share this guide with your colleagues to ensure that everyone understands the rights and responsibilities in the event of an ICE visit. If you have more questions, reach out to our team at Berardi Immigration Law to talk to an experienced immigration attorney.