In recent months, federal agents slept in the lobby Southern California hospitals, guarded detained patients – sometimes constrained – in hospital wardsAnd stalked immigrant landscape designer to the surgery center.
U.S. Immigration and Customs Enforcement agents also showed up at community clinics. Medical professionals say officers tried enter the parking lot hosted a mobile clinic, waved an assault rifle in the faces of doctors serving the homeless, and dragged a passerby into an unmarked car outside a community health center.
In response to such immigration enforcement activity in and around clinics and hospitals, Democratic Gov. Gavin Newsom last month signed SB 81which prohibits health care facilities from allowing federal agents without a valid search warrant or court order into private premises, including places where patients receive treatment or discuss health matters.
But while the bill has received broad support from medical groups, health care workers and immigrant rights advocates, legal experts say California cannot prevent federal authorities from carrying out their duties in public spaces, including hospital lobbies and general waiting areas, health care parking lots and surrounding areas – places where recent ICE actions have sparked outrage and fear. Previous federal restrictions on immigration enforcement in or near sensitive areas, including health care facilities, were lifted by the Trump administration in January.
“The problem that states face is supremacy clause,” said Sofia Genovesesenior attorney and fellow at Georgetown Law School. She said the federal government has the authority to conduct enforcement actions and there are limits to what the state can do to stop them.
California law defines a patient's immigration status and place of birth as protected information that, like medical records, cannot be disclosed to law enforcement without a warrant or court order. And it requires health care facilities to have clear procedures for handling requests from immigration authorities, including training staff to immediately notify a designated administrator or legal counsel if agents ask to enter a private area or view patient records.
Several other Democratic-led states have also passed laws to protect patients at hospitals and health centers. Colorado Gov. Jared Polis signed the agreement in May. Civil Rights Protection Immigration Status a bill that would punish hospitals for unauthorized release of information about people in the country and would prohibit ICE agents from entering the private premises of health care facilities without a court warrant. In Maryland law The requirement for the attorney general to develop guidelines for keeping ICE out of health care facilities took effect in June. New Mexico established new patient data protectionand Rhode Island has prohibited medical institutions from patients' questions about their immigration status.
Republican-led states have joined federal efforts to prevent immigrants from spending health care without legal authorization. Such immigrants are not eligible for comprehensive Medicaid coverage, but states bill the federal government for urgent Care in certain cases. Under law coming into force in 2023Florida requires hospitals accepting Medicaid to ask about a patient's legal status. In Texas, hospitals must now report how much they spend caring for immigrants without legal authorization.
“Texans should not bear the burden of financially supporting health care for undocumented immigrants,” Gov. Greg Abbott said in a statement. decree last year.
California's efforts to rein in federal enforcement come as a state where more than a quarter of its residents born abroadbecame the target of President Donald Trump's immigration crackdown. Newsom signed SB 81 as part of package of bills ban immigration agents from entering schools without a warrant, require law enforcement officers to identify themselves and prohibit officers from wearing masks. SB 81 passed on a party-line vote without formal opposition.
“We are not North Korea,” Newsom said during a bill signing ceremony in September. “We resist these authoritarian tendencies and the actions of the current administration.”
Some bill supporters and legal experts said the California law could prevent ICE from violating patients' existing privacy rights. These include the Fourth Amendment, which prohibits searches without a warrant in places where people have a reasonable expectation of privacy. Valid guarantees must be issued by the court and signed by the judge. But ICE agents often use administrative warrants to try to gain access to private areas they don't have the authority to enter, Genovese said.
“People don't always understand the difference between an administrative order, which is a meaningless piece of paper, and a judicial order, which is enforceable,” Genovese said. She said bench warrants are rarely issued in immigration cases.
This was reported by the Department of Homeland Security he won't enforce California's mask ban or ID requirements for law enforcement officers, calling them unconstitutional. The department did not respond to a request for comment on the state's new rules for health care facilities, which took effect immediately.
Tanya Broder, senior counsel at the National Immigration Law Center, said arrests of immigrants in medical facilities are relatively rare. But the federal decision to lift protections in sensitive areas, she said, has “created fear and uncertainty across the country.” Many of the most high-profile news reports about immigration agents in health care facilities have emerged in California, and have largely involved detained patients being brought in for treatment.
The California Nurses Association, the state's largest nurses union, co-sponsored the bill and raised concerns about the treatment of Milagro Solis-Portillo, a 36-year-old Salvadoran woman who was under 24-hour ICE surveillance at Glendale Memorial Hospital over the summer.
Trade union leaders also condemned the presence agents at California Hospital Medical Center south of downtown Los Angeles. Agents brought the patient in on Oct. 21 and remained in the room for nearly a week, said Anne Caputo-Pearl, a labor and delivery nurse and the hospital's chief union representative. Los Angeles Times reported that TikTok streamer Carlitos Ricardo Parias was taken to the hospital that day after being shot during an immigration enforcement operation in South Los Angeles.
ICE's presence frightened nurses and patients and led to restrictions on visitors to the hospital, Caputo-Pearl said. “We want better clarification,” she said. “Why are these agents allowed in the room?”
But hospital and clinic officials said they are already following the law, which greatly increases extensive manual brought forward by state Attorney General Rob Bonta in December.
Community clinics across Los Angeles County, which serve more than 2 million patients a year, including a significant immigrant population, have been implementing the attorney general's recommendations for months, said Louise McCarthy, president and CEO of the Los Angeles County Community Clinic Association. But she said the law should help ensure uniform standards across all health care providers the clinics use and reassure patients that procedures are in place to protect them.
However, this cannot prevent immigration raids in the wider community, which have left some patients and even health workers fearful go outside'” McCarthy said. She said there have been some incidents near the clinics, including the arrest of a bystander outside an East Los Angeles clinic that was captured on video by a security guard.
“The clinic staff asked: “Is it safe for to me come out?” she said.
General Director St. John's Community Health, a chain of 24 community health centers and five mobile clinics in South Los Angeles and the Inland Empire, Jim Mangia agreed that the new law may not prevent all immigration enforcement activity, but he said it gives clinics a tool to counter if agents show up, something his staff has already had to do.
Mangia said St. John staff met with immigration agents twice over the summer. In one, he said, officers prevented armed officers from entering a locked parking lot at a drug and alcohol rehabilitation center where doctors and nurses were seeing patients in a mobile health clinic.
Another incident occurred in July when immigration agents went down to MacArthur Park on horseback and in armored vehicles, a show of force from the Trump administration. Mangia said officers wearing masks and full tactical gear surrounded an outdoor medical tent where St. John's Hospital workers were treating homeless patients, yelling at staff to get out and pointing a gun at them. Mangia said doctors were so shocked by the episode that he had to bring in mental health professionals to help them feel safe returning to the streets.
A DHS spokesperson told CalMatters that in the rare event that agents enter certain sensitive locations, officers will need to “secondary supervisor approval“
Since then, St. John's has redoubled its efforts to support and train staff and offer home visits and grocery deliveries to patients afraid to go outside. Mangia said patient fears and ICE activity have subsided since the summer, but DHS plans hire 10,000 more ICE agentshe doubts it will last long.
