This past July, Jose de Jesus Martinez watched his 16-year-old son fight for his life in a hospital in San Antonio, Texas.
The boy had been injured when being smuggled across the Mexican border.
While at the medical facility, Martinez was approached by U.S. Immigration and Customs Enforcement (ICE) agents.
“The incident was just one in a recent trend of disturbing actions by ICE agents at or near hospitals and other healthcare facilities,” wrote Dr. Altaf Saadi, Sameer Ahmed, JD, and Dr. Mitchell Katz, in a recently penned editorial in the Journal of the American Medical Association (JAMA) about the need for sanctuary hospitals.
Like churches, hospitals are treated as “sensitive spaces.”
This means that anyone can go there to be treated regardless of immigration status or ability to pay.
That protection is specified under the Emergency Medical Treatment and Labor Act (EMTALA).
“This law also includes documentation status, meaning that regardless [of it] the individual has to be treated. Once stabilized, that person is released from the ER regardless of if the emergent condition that led to the ER has been fully addressed,” Tiffany D. Joseph, PhD, an assistant professor of sociology at Stony Brook University, told Healthline.
Places that aren’t ‘safe’
The issue, however, doesn’t end at medical centers.
Unlike hospitals and churches, workplaces aren’t considered sensitive locations.
As a result, ICE can conduct raids at health-related places such as workers’ compensation offices.
Joseph believes this type of action has increased under the current presidential administration.
“It is likely that undocumented immigrants who live in states where they can and do file workers’ comp claims may be vulnerable to ICE intervention,” Joseph noted.
Saadi told Healthline that previous administrations understood the need to ensure that everyone felt secure when accessing medical care.
ICE and U.S. Customs and Border Protection (CBP) agents would follow policies not to conduct enforcement actions at sensitive locations, such as hospitals, schools, and places of worship.
“But in the current administration, ICE and CBP agents no longer appear to be following those policies,” Saadi said.
She cited the case of a 10-year-old girl taken into custody as she was transported through a checkpoint on her way to a hospital for emergency surgery.
The girl was held at a facility until she was recently released.
Hospitals as ‘safe spaces’
Dr. Parveen Parmar, a doctor at Los Angeles County+USC Medical Center, has worked with Physicians for Human Rights.
The group advocates for all people to have access to healthcare.
She says her medical center has a process in place to prevent patients from being taken abruptly. If a warrant is presented, the administration must review the request.
“This applies to everyone, such that patients can’t be easily taken should ICE show up, for example,” Parmar told Healthline.
She believes patients shouldn’t be removed from a hospital for many reasons. One of the most important is that preventable illness or death could result if an individual can’t seek care.
“As a physician, I would be horrified to hear that a child became ill because her undocumented mother was afraid to bring her to our emergency department,” she said.
Parmar called these cases of workers’ compensation claims leading to ICE arrests “disturbing.”
“There is no excuse for an employer deciding to exploit someone’s legal status as retribution for making a legitimate claim after an injury,” she said. “Our undocumented immigrant population is very often involved in hard, backbreaking labor. To turn someone over because they develop an injury, after having exploited their inexpensive labor, is unconscionable.”
How a ‘sanctuary hospital’ works
The authors of the JAMA editorial say that medical professionals should support undocumented immigrants by allowing hospitals to be sanctuaries.
But what would that entail, exactly?
They call for hospitals to be regarded as sanctuary spaces and devise policies and procedures to help patients handle communication with ICE agents while in a hospital or filing a workers’ compensation claim.
“If ICE agents come to the hospital, for example, their identification should be verified, and absent an emergency such as to avoid immediate harm or criminal activity, no hospital employee should provide information about any patient to the agents or provide them access to any patient’s room without a court-ordered warrant or subpoena,” they wrote.
It’s also important for hospitals to take precautions before cooperating with ICE even when the stated objective of the ICE encounter doesn’t involve an investigation or enforcement action against specific patients, they added.
Saadi told Healthline that the physicians aren’t advocating for illegal immigrants to be able to stay in a hospital indefinitely to avoid immigration enforcement.
Her goal is to ensure that anyone can get access to healthcare.
For instance, sanctuary hospitals would have protections such as not collecting patients’ immigration status or sharing it with ICE.
That could include keeping information from ICE unless the agency has a court-ordered warrant or subpoena.
Other protections could include displaying signage about patients’ rights to stay silent if questioned by an agent.
After Saadi’s article was published, she said she heard from others in the medical community who agreed with designating hospitals as “sensitive locations” as many hospitals in California have done.
“It’s important to have these policies and guidelines in place proactively, before ICE or Customs and Border Patrol show up in the hospital and jeopardize someone’s access to healthcare,” she noted.
The policy establishing hospitals as sensitive locations was launched in a 2011 Department of Homeland Security memo.
Because it’s not set in stone, the policy could change if hospitals don’t take action to devise their own guidelines.
Sarang Sekhavat, federal policy director for the Massachusetts Immigrant and Refugee Advocacy Coalition, recently said that policy could end if President Trump chooses to do so.
Joseph said that removing that policy would put healthcare providers and facilities in a “precarious position.”
She added that facilities would have to implement policies to uphold the protections in the event that the policy is rescinded.
Though immigrants are currently protected, studies have shown that they are still apprehensive about seeking medical care due to their immigration status.
According to Joseph’s research, those who feel safe going to hospitals have a fear of being profiled and pulled over on the way there.
“Even if there are sanctuary hospitals, the broader socio-political climate and increased ICE enforcement will still deter immigrants from seeking care out of fear of deportation for themselves or their loved ones,” she explained.