Southern California Health Care Providers Confront Immigration Enforcement Officials

In Southern California, which has become the epicenter of large-scale protests against the Trump Administration’s immigration policies, hospitals, surgery centers, and clinics have recently had encounters with US Immigration and Customs Enforcement (ICE) officials on or near their premises.

As a result, health care providers are grappling with complex legal and operational questions about how to respond if immigration enforcement officials appear at their facilities, and what steps they must take to protect patient rights and comply with the law.

ICE Activity at Southern California Health Care Facilities: What Is Happening and Why

In the past several weeks, multiple health care facilities in Southern California have reported direct encounters with immigration enforcement officials. At Ontario Advanced Surgical Center, for example, a high-profile incident occurred when ICE officers, conducting a roving immigration operation, pursued a man suspected of being in the country unlawfully onto the surgery center’s premises. According to federal authorities, the individual was not a patient but ran inside the facility seeking cover. As ICE officers attempted to detain him, two staff members in medical scrubs allegedly physically intervened, with one staffer reportedly wedging herself between the officer and the individual, pushing the officer, and shouting for the release of the man, while another allegedly grabbed the officer’s arm and vest. The confrontation escalated, and the officers ultimately detained the individual after additional staff became involved. The two staff members now face the possibility of significant federal prison sentences after federal prosecutors charged them with assaulting a federal officer and conspiracy to prevent, by force and intimidation, a federal officer from discharging his duties.

Similar law enforcement presence has been observed at other facilities in Southern California, including St. John’s Community Health, Glendale Memorial Hospital, and Riverside Community Hospital. Officers have been seen in parking lots, lobbies, and attempting to access non-public patient care areas. These increased interactions are directly tied to recent federal policy changes that have expanded the circumstances under which immigration enforcement actions may occur. As we reported in a prior alert, in January, the US Department of Homeland Security rescinded prior guidance that had designated hospitals, clinics, and other health care facilities as “protected areas,” where immigration enforcement was generally discouraged. Reflecting a broader national strategy to increase immigration enforcement, the new directive authorizes ICE and US Customs and Border Protection personnel to conduct enforcement actions in or near health care settings, relying on officer discretion and a “common sense” standard. Now, ICE officers are more likely to seek entry to health care facilities, request information about patients or visitors, and attempt to detain individuals suspected of immigration violations — even in the absence of criminal conduct. The impact is immediate. Facilities are reporting a sharp increase in appointment cancellations, a decline in emergency department visits, and heightened fear among patients and staff, particularly in immigrant communities.

Legal and Liability Considerations: Lessons From Recent Encounters

Recent events in Southern California underscore the importance of understanding the limits of law enforcement authority and health care facilities’ obligations under federal and state law. For example, ICE officers may enter public areas such as lobbies and parking lots, but access to non-public areas, including patient care zones and administrative offices, requires a judicial search warrant signed by a judge or the facility’s voluntary consent. As we discussed in a prior alert, patient information, including immigration status when linked to other identifiable health information, is protected under the Health Insurance Portability and Accountability Act and generally cannot be disclosed to law enforcement without patient authorization or a valid court order. Staff who are unprepared or act outside established protocols risk exposing the facility to civil penalties, reputational harm, and even criminal liability.

Health care providers should take practical and proactive steps to be prepared for an immigration enforcement action that may occur at their facility, including the following:

• Update and Communicate Internal Policies: Review and revise policies on law enforcement interactions to address immigration enforcement specifically. Designate a primary point of contact (POC) within the legal or compliance department to manage all ICE inquiries and visits.

• Train Staff and Security: Ensure all staff, especially those at reception and security, are trained to refer immigration enforcement officials to the designated POC and not to consent to searches or provide information independently.

• Require Proper Legal Documentation From Officials: Require immigration enforcement officials to present identification and the legal basis for their request. If presented with an administrative warrant, inform officials that it does not authorize entry to non-public areas.

• Accompany Officials, But Do Not Obstruct Them: If immigration enforcement officials are permitted on the premises, ensure they are accompanied at all times and directed to non-patient areas for discussions. However, staff should not physically interfere with or obstruct officials in the performance of their duties. The recent criminal charges against staff at Ontario Advanced Surgical Center highlight the serious legal risks, including potential prosecution and imprisonment, of attempting to block or impede federal officers during an enforcement action.

• Safeguard Patient Privacy: Do not disclose patient information, including immigration status, without a valid court order or patient authorization. Limit documentation of immigration status in medical records to situations where it is medically necessary.

• Document and Review All Incidents: Maintain detailed records of all law enforcement encounters, including names and badge numbers of agents, time and location, and actions taken. Conduct post-incident reviews to identify policy or training gaps and update protocols as needed.

• Provide Patient Resources: Offer patients information about their rights and access to legal resources if requested.

Key Takeaways

Immigration enforcement actions at health care facilities in Southern California are a present reality, not a distant possibility. The evolving federal enforcement landscape demands that health care providers implement robust policies, comprehensive staff training, and vigilant legal oversight to protect patient rights and institutional interests. Recent encounters have demonstrated that preparation and adherence to legal protocols are essential to minimizing liability and maintaining trust with patients and the community. In this rapidly changing environment, working closely with experienced legal counsel is critical to ensuring compliance and continuing to provide safe and accessible health care to all.

For further information or assistance in preparing for an immigration enforcement action at your facility, please contact one of the authors of this alert or the usual ArentFox Schiff attorney who handles your matters.