WA hospitals issue guidance on what to do if ICE arrives

Many Washington medical facilities and staffers are taking steps to ready themselves for the potential presence of federal immigration officers, following President Donald Trump’s renewed focus on deportation efforts.

State health care leaders released guidance this week for hospitals and nurses that told them what they could do, and not do, if Immigration and Customs Enforcement agents show up. The recommendations come in response to a recent Trump administration order that targets “sanctuary” jurisdictions and vows to prioritize identifying and detaining undocumented immigrants.

In addition, the U.S. Department of Homeland Security has rescinded previous policies that established medical facilities — in addition to schools, churches and other places that provide essential services — as “protected areas” largely shielded from federal immigration enforcement action.

While Cassie Sauer, president and CEO of the Washington State Hospital Association, said Friday she hadn’t heard of any hospitals experiencing recent immigration enforcement action, she said she worries that their presence would discourage patients, particularly those without documentation, from seeking health care.

“I’m really hoping hospitals are not the place of focus” when it comes to immigration-related searches and arrests, Sauer said. “We really want to be a place of healing for everyone and where people feel like they’ve got the confidence to come.”

WSHA is encouraging hospitals to designate an on-call administrator, who is trained in accessing legal resources, to respond to immigration enforcement cases. There’s typically someone to whom front desk staffers can escalate certain issues, such as if local law enforcement or someone from the media shows up unexpectedly, but now that person (or another administrator) should also be ready to handle immigration-related issues, Sauer said.

Hospital staffers, including those at the front desk, should neither confirm nor deny the presence of a patient to an ICE officer and should instead route the officer to the hospital’s designated point person, according to the guidance, which is largely based on 2020 instruction from the office of Bob Ferguson, then the attorney general and now Washington’s governor.

At MultiCare, which has hospitals and clinics throughout the Puget Sound area, and around Yakima and Spokane, go-to staffers for immigration-related issues will soon be available at all facilities, according to spokesperson Scott Thompson.

“MultiCare believes, as with places of worship and children’s schools, the health care environment is a sacred place,” Thompson said in a statement. “We also believe that maintaining a safe place to receive care is essential to our mission.”

UW Medicine hospitals have also appointed representatives for handling ICE officers, hospital spokesperson Susan Gregg said.

“Things are changing rapidly, and it is not yet fully clear how new policies or laws will be applied in our setting,” Gregg wrote. “We are working diligently and as swiftly as possible to ensure both compliance with the law and the safety and well-being of our patients, clinicians, and staff.”

In addition, the WSHA guidance reminds hospitals that a demand from ICE or U.S. Customs and Border Protection is “not sufficient” to gain access to patients, patient records or “private” areas of the hospital.

Hospitals and clinics in Washington do not ask about citizenship or immigration status during patient intake. And per federal patient privacy laws, hospitals will not provide any identifying information about patients, unless presented with a court order or a valid, legal document signed by a judge, Sauer said.

Providing immigration information is also never a condition of receiving care, Thompson added.

“Without a lawfully executed summons or warrant, an ICE agent has no more access to the patient or their information than any member of the general public who enters your workplace,” the Washington State Nurses Association, one of the largest nurse unions in the state, wrote in their own set of reminders for members.

Without a subpoena or warrant, ICE officers cannot force staffers to answer questions, open the door or provide any documents, WSNA told members.

Lastly, Sauer recommended that undocumented patients consider opting out of hospitals’ patient directories, which front desk staffers typically use to verify if a patient is there or to route calls to them.

“Hospitals are doing all they can to remain accessible, open and welcoming to patients,” Sauer said. “We treat all kinds of people who do all kinds of things that someone else might not like. You’re driving drunk, you get in a gunfight, you use drugs, you have unprotected sex. We have no judgment. Come through the door and we’re going to do everything we can to make you better.”

She added: “People have feelings about immigration. In my mind, that should be exercised somewhere else. … It’s not in the public’s interest to exclude people from health care.”

Across the state, leaders of individual health care organizations have sent their own messages to staffers and kept a close watch on federal guidance.

On Monday, Providence President and CEO Erik Wexler wrote to staffers that he was aware of all their questions about Trump’s executive orders, and that “it is important to remember that federal patient privacy laws are still in effect.”

“In accordance with these laws, we want to reassure all patients that we will continue to safeguard their privacy and protected health information, regardless of citizenship or immigration status,” Wexler wrote.

Kelli Nomura, CEO of International Community Health Services, also said in a statement that clinics would not provide any patient information to federal immigration officers, except “as is required by law.” She added that ICHS, a Seattle-based federally qualified health center that has historically served the Asian American and Pacific Islander community and patients of color, has systems and processes in place “to deal with law enforcement at all levels.”