Hospitals across the US are bracing for possible immigration arrests taking place within their walls following a recent Trump administration policy change.
One day after Trump took the oath of office, the Department of Homeland Security rescinded an Obama-era policy that prevented Immigration and Customs Enforcement (ICE) from making arrests in “sensitive” areas such as hospitals, schools, and churches.
In response, hospital leaders should train workers on interacting with law officials and create standardized protocols to follow in case of immigration enforcement actions, Magda Rodriguez, a healthcare attorney and partner at Day Pitney law firm, told Healthcare Brew.
“You have to train your staff, you have to reinforce your current policies, because…you don’t want to get caught off guard,” Rodriguez said.
Step-by-step. Hospitals should first establish a clear “chain of command” so all staff know where to turn for guidance if and when immigration enforcement officials show up, according to Rodriguez.
“You want to have a uniform approach where someone feels comfortable always going back to the same person, so that chain of command is consistent,” Rodriguez said.
Hospital staff should be trained on which patient data they’re required to give officials and under which circumstances, she added. HIPAA rules mean healthcare workers are generally prohibited from disclosing immigration status unless presented with a proper warrant or subpoena, according to Rodriguez.
Not every hospital tracks immigration status, but Florida and Texas both mandate all hospitals receiving Medicaid funding (which is the vast majority of US hospitals) track the number of undocumented patients treated and tally how much their care costs.
“Healthcare workers are really going to have to be fully trained and understand what a valid subpoena and warrant look like so they don’t inadvertently disclose information that they shouldn’t otherwise disclose,” Rodriguez said.
Navigate the healthcare industry
Healthcare Brew covers pharmaceutical developments, health startups, the latest tech, and how it impacts hospitals and providers to keep administrators and providers informed.
In addition, hospitals should make patients aware of their rights, she added. For instance, even though hospitals in Florida and Texas are required to ask patients about their immigration status, patients don’t have to answer.
Some hospitals in Massachusetts have posted patient privacy rights in multiple languages around emergency departments and waiting rooms in response to the updated ICE policy, KFF Health News reported.
The consequences. While it’s not certain ICE officials will attempt arrests at hospitals just because it’s now permitted, hospitals are generally taking a better-safe-than-sorry approach, Rodriguez said.
“I think everybody has a feeling that it’s coming,” Rodriguez said.
And if it does, a major concern among healthcare workers is that more people will avoid seeking care out of fear, Mel Wilson, senior policy consultant at the National Association of Social Workers, told Healthcare Brew.
“It’s almost logical to think that unless there is truly a life and death situation, [undocumented individuals] probably would wait a long time before they would actually go in to get treatment or services,” he said.
Two healthcare worker unions—1199SEIU United Healthcare Workers East, which represents more than 450,000 workers nationwide, and the New York State Nurses Association, which represents 42,000 nurses—released a joint statement on Feb. 10 denouncing the policy, saying it “creates an atmosphere of fear in our communities that dissuades people from seeking necessary care.”
“We cannot protect against the next public health emergency if millions of US residents are unable to safely go to an emergency room or receive preventative care,” the statement read.
The American Hospital Association declined to comment on the matter.