II. Management: Healthcare Facilities
- Schools, worship places and healthcare facilities were protected from ICE as sensitive areas until January 2025
- U.S. Fourth amendment protects against unreasonable search and Seizure in situations of expected privacy
- Healthcare centers may limit access to spaces and records inaccessible to the general public (except with valid warrant)
- Immigration officers within a facility (e.g. accompanying a patient) may be restricted access to unrelated private spaces
- May be restricted from other patient's rooms, secure treatment areas and internal waiting areas
- Boundaries to restricted areas may be delineated with signs and physical boundaries (e.g. badge-limited entry)
III. Management: Clinician Documentation
- HIPAA protection is not absolutely protected (and varies with U.S. administration)
- Do not record immigration status in the medical record
- Documentation should be relevant, objective and limited to that necessary for medical care
- Use neutral language (e.g. immigration-related stressors, insurance ineligibility)
- Country or birth or transit should be documented only if relevant to medical condition
IV. Complications: ICE Medical Impact
- Delayed healthcare
- Medication nonadherance
- Medical insurance coverage lapses
- Trauma or Violence related to ICE activities
- Patient psychosocial stress
- Mass deportations
- Potential detention and deportation for themselves, friends and family
- Care of their family if they were absent
- Moral Injury to healthcare workers
- Sense that health worker is unable to deliver ethical, quality care in the context of system contraints
V. Resources: Clinical Guidance
- Advocating On Behalf of Patients in Immigration Custody: A Resource for Health Care Providers and Medical Staff (NILC)
- Health Care and U.S. Immigration Enforcement: What Providers Need to Know (PHR)
VI. Resources: Individual Guidance
- Know Your Rights: What to Do if You Are Arrested or Detained by Immigration (NILC)
- Family Preparedness Plan (ILRC)
- National Immigration Detention Hotline
- Online Detainee Locator