Claudia Boyd-Barrett
In latest months, federal brokers have camped out in the lobby of a Southern California hospital, guarded detained patients — generally shackled — in hospital rooms, and chased an immigrant landscaper right into a surgical middle.
U.S. Immigration and Customs Enforcement brokers have additionally proven up at group clinics. Health suppliers say that officers have tried to enter a parking lot internet hosting a cell clinic, waved a machine gun within the faces of clinicians serving the homeless, and hauled a passerby into an unmarked automobile outdoors a group well being middle.
In response to such immigration enforcement exercise in and round clinics and hospitals, Democratic Gov. Gavin Newsom final month signed SB 81, which prohibits medical institutions from permitting federal brokers with no legitimate search warrant or court docket order into non-public areas, together with locations the place sufferers obtain remedy or focus on well being issues.
But whereas the invoice obtained broad help from medical teams, well being care staff, and immigrant rights advocates, authorized specialists say California can’t cease federal authorities from finishing up duties in public locations, which embrace hospital lobbies and normal ready areas, well being facility parking heaps, and surrounding neighborhoods — locations the place latest ICE actions have sparked outrage and concern. Previous federal restrictions on immigration enforcement in or close to delicate areas, together with well being care institutions, had been rescinded by the Trump administration in January.
“The issue that states encounter is the supremacy clause,” stated Sophia Genovese, a supervising lawyer and scientific educating fellow at Georgetown Law. She stated the federal authorities does have the precise to conduct enforcement actions, and there are limits to what the state can do to cease them.
California’s regulation designates a affected person’s immigration standing and birthplace as protected data, which like medical data can’t be disclosed to regulation enforcement with no warrant or court docket order. And it requires well being care services to have clear procedures for dealing with requests from immigration authorities, together with coaching employees to right away notify a delegated administrator or authorized counsel if brokers ask to enter a personal space or overview affected person data.
Several different Democratic-led states have additionally taken up laws to guard sufferers at hospitals and well being facilities. In May, Colorado Gov. Jared Polis signed the Protect Civil Rights Immigration Status invoice, which penalizes hospitals for unauthorized sharing of details about individuals within the nation illegally and bars ICE brokers from coming into non-public areas of well being care services with no judicial warrant. In Maryland, a law requiring the lawyer normal to create steerage on holding ICE out of well being care services went into impact in June. New Mexico has instituted new patient data protections, and Rhode Island has prohibited health care facilities from asking sufferers about their immigration standing.
Republican-led states have aligned with federal efforts to stop well being care spending on immigrants with out authorized authorization. Such immigrants are usually not eligible for complete Medicaid protection, however states do invoice the federal authorities for emergency care in sure instances. Under a law that took effect in 2023, Florida requires hospitals that settle for Medicaid to ask a couple of affected person’s authorized standing. In Texas, hospitals now must report how a lot they spend on look after immigrants with out authorized authorization.
“Texans should not have to shoulder the burden of financially supporting medical care for illegal immigrants,” Gov. Greg Abbott stated in issuing his executive order final 12 months.
California’s efforts to rein in federal enforcement come because the state, the place greater than 1 / 4 of residents are foreign-born, has grow to be a goal of President Donald Trump’s immigration crackdown. Newsom signed SB 81 as a part of a bill package prohibiting immigration brokers from coming into faculties with no warrant, requiring regulation enforcement officers to establish themselves, and banning officers from carrying masks. SB 81 was handed on a party-line vote with no formal opposition.
“We’re not North Korea,” Newsom stated throughout a September bill-signing ceremony. “We’re pushing back against these authoritarian tendencies and actions of this administration.”
Some supporters of the invoice and authorized specialists stated California’s regulation can stop ICE from violating current affected person privateness rights. Those embrace the Fourth Amendment, which prohibits searches with no warrant in locations the place individuals have an affordable expectation of privateness. Valid warrants should be issued by a court and signed by a judge. But ICE brokers steadily use administrative warrants to attempt to acquire entry to personal areas they don’t have the authority to enter, Genovese stated.
“People don’t always understand the difference between an administrative warrant, which is a meaningless piece of paper, versus a judicial warrant that is enforceable,” Genovese stated. Judicial warrants are hardly ever issued in immigration instances, she added.
The Department of Homeland Security has stated it won’t abide by California’s mask ban or identification necessities for regulation enforcement officers, slamming them as unconstitutional. The division didn’t reply to a request for touch upon the state’s new guidelines for well being care services, which went into rapid impact.
Tanya Broder, a senior counsel with the National Immigration Law Center, stated immigration arrests at well being care services seem like comparatively uncommon. But the federal choice to rescind protections round delicate areas, she stated, “has generated fear and uncertainty across the country.” Many of essentially the most high-profile information experiences of immigration brokers at well being care services have been in California, largely involving detained sufferers introduced in for care.
The California Nurses Association, the state’s largest nurses union, was a co-sponsor of the invoice and raised considerations concerning the remedy of Milagro Solis-Portillo, a 36-year-old Salvadoran lady who was beneath round the clock ICE surveillance at Glendale Memorial Hospital over the summer time.
Union leaders additionally condemned the presence of brokers at California Hospital Medical Center south of downtown Los Angeles. According to Anne Caputo-Pearl, a labor and supply nurse and the chief union consultant on the hospital, brokers introduced in a affected person on Oct. 21 and remained within the affected person’s room for nearly per week. The Los Angeles Times reported {that a} TikTok streamer, Carlitos Ricardo Parias, was taken to the hospital that day after he was wounded throughout an immigration enforcement operation in South Los Angeles.
The presence of ICE was intimidating for nurses and sufferers, Caputo-Pearl stated, and prompted customer restrictions on the hospital. “We want better clarification,” she stated. “Why is it that these agents are allowed to be in the room?”
Hospital and clinic representatives, nonetheless, stated they’re already following the regulation’s necessities, which largely reinforce extensive guidance put out by state Attorney General Rob Bonta in December.
Community clinics all through Los Angeles County, which serve over 2 million sufferers a 12 months, together with a big portion of immigrants, have been implementing the lawyer normal’s pointers for months, stated Louise McCarthy, president and CEO of the Community Clinic Association of Los Angeles County. But she stated the regulation ought to assist guarantee uniform requirements throughout well being services that clinics refer out to and reassure sufferers that procedures are in place to guard them.
Still, it may’t stop immigration raids from occurring within the broader group, which have made some sufferers and even well being staff afraid to venture outside, McCarthy stated. Some incidents have occurred close to clinics, together with an arrest of a passerby outdoors a clinic in East Los Angeles, which a safety guard caught on video, she stated.
“We’ve had clinic staff say, ‘Is it safe for me to go out?’” she stated.
At St. John’s Community Health, a community of 24 group well being facilities and 5 cell clinics in South Los Angeles and the Inland Empire, CEO Jim Mangia agreed that the brand new regulation can’t stop all immigration enforcement exercise, however he stated it does give clinics a instrument to push again if brokers present up, one thing his employees has already needed to do.
Mangia stated St. John’s employees had two encounters with immigration brokers over the summer time. In one, he stated, employees stopped armed officers from coming into a gated parking zone at a drug and alcohol restoration middle the place docs and nurses had been seeing sufferers at a cell well being clinic.
Another occurred in July, when immigration brokers descended upon MacArthur Park on horses and in armored automobiles, in a present of power by the Trump administration. Mangia stated masked officers in full tactical gear surrounded a road drugs tent the place St. John’s suppliers had been tending to homeless sufferers, screamed at employees to get out, and pointed a gun at them. The suppliers had been so shaken by the episode, Mangia stated, that he had to herald psychological well being professionals to assist them really feel secure going again out on the road.
A DHS spokesperson instructed CalMatters that within the uncommon occasion the place brokers enter sure delicate areas, officers would wish “secondary supervisor approval.”
Since then, St. John’s has doubled down on offering help and coaching to employees and has provided sufferers afraid to exit the choice of house medical visits and grocery deliveries. Patient fears and ICE exercise have decreased because the summer time, Mangia stated, however with DHS planning to hire an additional 10,000 ICE agents, he doubts that may final.
