Immigration questions answered: Review UC policies and patient resources

Last week, the Department of Homeland Security, Immigration and Customs Enforcement (ICE) rescinded a 2021 internal memo that directed ICE officers to generally avoid conducting enforcement activities at protected areas, including hospitals.

We do not yet know if this change in policy will result in increased enforcement activities at hospitals, but we do want to remind you that the laws that a hospital must follow have not changed. ICE still requires a warrant to enter private areas of a health care facility, such as interior areas or those marked “private,” unless staff consent to the search.

However, public areas like lobbies, waiting areas, and parking lots do not require a warrant. As a reminder, personnel should do the following if an officer makes a request for access or information for immigration enforcement purposes:

1. Advise the officer that before proceeding with their request, you must first notify and receive direction from the Site Administrator or Administrator on Duty/Call and legal counsel.
2. Notify the Site Administrator or Administrator on Duty/Call and legal counsel.
3. Advise the officer that the health facility is not obstructing the officer’s process and direct them to speak to the Site Administrator or Administrator on Duty/Call if the officer raises objections or poses questions.
4. Ask to see the officer’s credentials (name and badge number). Also, ask for the officer’s business card if they have one. Write down the officer’s name, badge number, and contact information.
5. Ask the officer to explain the purpose of their visit and note the response.
6. Ask the officer if they have any documentation that authorizes health facility access, and if they do, ask the officer to produce such documentation. Make copies of all documents provided by the officer. Provide to legal counsel.
7. The response will depend upon the type of documentation they provide.
8. If the officer orders staff to provide immediate access to facilities, comply with the officer’s order and immediately contact the Site Administrator or Administrator on Duty/Call and legal counsel.  Do not physically interfere with the officer. If an officer enters the premises without authority, document the officer’s actions while at the facility.

UC Davis Health guidance

UC Davis Health is dedicated to ensuring fair treatment and access to health care for individuals of all genders, races, backgrounds, or identities. We remain steadfast in serving our community with dignity and privacy, guided by our Principles of Community and established policies.

We recognize the recent changes around immigration enforcement may raise fears or concerns for some patients, employees, and loved ones.

At UC Davis Health, we do not ask for immigration status before delivering care, and we protect the privacy of all patients to the greatest extent of policies and laws. This message provides information about our policies, resources, and escalation protocols.

It is not unusual for law enforcement, including occasionally immigration enforcement officers (ICE), to be present in our facilities as part of our treatment of in-custody patients. This has been the case for years, and despite new federal orders and changes in guidance to DHS, there is no indication, at this time, that we should expect to see any changes in federal or state law enforcement practices in our hospital. Our colleagues at the University of California Police Department (UCPD) are in regular contact with law enforcement at all levels and will be involved in any law enforcement activity in our hospitals.

UC Davis Health, especially our Emergency Department, regularly cares for individuals in the custody of law enforcement agencies, including federal law enforcement and sometimes ICE. UC Davis Health remains committed to providing the best care for all individuals, regardless of their circumstances.

Please review the policies below as needed. They provide instructions on interacting with immigration and law enforcement and were developed to protect our patients’ dignity and privacy.

Policies and procedures:

Existing policies remain in effect, with no changes.

This includes the following:

• Policy 2403 (Responding to Immigration Enforcement)
• Policy 2426 (Disclosing PHI to Law Enforcement)
• Policy 2410 (Allowable Uses of PHI)
• All UC Davis Health policies can be accessed through the Ellucid Policy Manager 

Care for in-custody patients:

UC Davis Health employees are expected to follow our long-established policies for caring for in-custody patients, including coordinating with the UC Davis Police Department and strictly adhering to patient privacy protections.

Care will be provided following established procedures for in-custody patients. If an immigration officer approaches you for information, please notify the Nursing Supervisor (office phone: 916-734-8505 or cell phone: 916-416-9881). The Nursing Supervisor will inform the UC Davis Police Department, the AOD, and the Chief Operating Officer. If we learn ICE intends to take an individual into custody, UCPD should be involved and should follow Policy 1252 (Treatment of Patients who are Incarcerated) and the current processes for transferring patients into law enforcement custody. These processes require the necessary documentation and coordination of custody transfer once the patient is medically stable.

Resources for patients and others:

These resources may be helpful in communicating or printing/posting for patients, but staff should make clear that they and the University are not providing legal advice.

• Updated UC Statement of Principles in Support of Undocumented Members of the UC Community
• Updated FAQs on possible federal immigration enforcement actions on UC property
• UCOP Policy: Responding to Immigration Enforcement
• UCOP: Know Your Rights information
• California Department of Justice: Promoting Safe and Secure Healthcare Access for All
• A list of California organizations accredited by the Board of Immigration Appeals (BIA) to represent immigrants before the DHS and Executive Office of Immigration Review (EOIR)
• The California Courts operate Self-Help Centers that may also be able to provide family-law assistance of relevance
• The California Courts Self-Help Guide also provides links to resources for free or low-cost legal help and guidance for hiring a lawyer
• A patient or their family member may be able to find legal assistance from legal-aid offices and lawyer-referral services at the California Department of Social Services website
• Nonprofit organizations that provide free or low-cost legal help may be found using the National Immigration Legal Services Directory
• A list of rapid response networks across California and Know Your Rights resources

Additional resources:

• California DOJ “Know Your Immigration Rights and Protection Under the Law” Consumer Alert
• California DOJ “Protect Yourself From Immigration Scams” Consumer Alert
• ACLU Know Your Rights page: If ICE Confronts You (English and Spanish versions)
• Immigrant Legal Resource Center: Step-by-Step Family Preparedness Plan
• Immigrant Legal Resource Center: Know Your Rights and What Immigrant Families Should Do Now
• National Immigration Law Center: Know Your Rights Resource

Next steps

Again, we do not foresee any changes in our hospital's federal or state law enforcement practices. If you encounter immigration enforcement seeking information, please immediately contact:

• UC Davis Police (916-734-2555), and,
• Nursing Supervisor (office phone: 916-734-8505 or cell phone: 916-416-9881).

Remember that patient privacy protections prevent sharing information about patients in our care. UC Davis Health leadership will continue to monitor developments and provide updates if the situation changes.

If patients are expressing fears or concerns to you or your team members, let them know that UC Davis Health does not collect information about immigration status, and federal patient privacy laws prevent health care organizations from sharing information about patients.

Additionally, California has several laws governing health information privacy, providing even stronger privacy protections than those contained in HIPAA.

We appreciate your ongoing commitment to providing safe and quality care to our patients.