How New England Providers Are Responding To A Call For 'Sanctuary Hospitals'

Nov 1, 2017

For immigrants in the country illegally, the fear of running into U.S. Immigration and Customs Enforcement (ICE) agents has made some public places appear threatening. In the current environment, that can include a visit to the emergency room.

For that reason, a recent opinion piece in the Journal of the American Medical Association called for the establishment of so-called 'sanctuary hospital' policies. But some New England health care providers say they only have so much power.

'Once ICE Walks In, It's Too Late'

In the chaos of a hospital, staff depends on procedure. So most hospitals have policies on interactions with law enforcement, like asking to see a warrant or subpoena. But what happens when an immigration agent asks about a patient?

"Yeah, that's a good question," said Rachel Labas, a spokesperson for Signature Healthcare Brockton Hospital. "I mean, we don't have any specific policies and to my knowledge, there's been no discussion around being kind of a safe haven hospital or anything like that. We're required by law to treat all patients, you know, without regard to their status, their immigration status, so that's not something that we've encountered."

With President Trump's new, tougher immigration enforcement actions, many in the healthcare field may be thinking about this question for the first time. Advocates for immigrants' rights say hospitals would be wise to prepare for these encounters in advance.

Sarang Sekhavat, federal policy director for the Massachusetts Immigrant and Refugee Advocacy Coalition, said it's crucial for hospitals and health care providers to have procedures in place.

"Once ICE walks in, it's too late to be dealing with this," Sekhavat said. "It's really important, I think, that all the staff at hospitals really understand what these policies are and how they should deal with ICE."

'It Would Almost Brand The Hospital'

As of now, ICE considers hospitals sensitive locations, along with schools and churches. This means agents will often avoid making arrests in these places. But, as we've seen recently in Texas, immigration officials are encroaching on these safe places. Ten-year-old Rosa Maria Hernandez, who is in the country illegally, was taken into custody after an emergency gall bladder surgery. Customs officials followed her ambulance to the hospital.

These so-called sensitive locations are not enshrined in law. They were established in a 2011 Department of Homeland Security memo and, Sekhavat said, could be rescinded with a stroke of the president's pen.

Joshua Abrams is an attorney for Partners HealthCare, the largest provider in the state. Like Signature Healthcare, it has no specific sanctuary policy in place. But, Abrams said, staff can try to remove themselves from the equation to an extent.

"We certainly have advised clinicians not to proactively ask about immigration status, not to document it unless it's for some reason necessary for the care being provided," Abrams said.

In other words, if they don't have the information, they can't share it.

At Catholic Medical Center in Manchester, one of New Hampshire’s largest hospitals, staff likely wouldn’t even know a patient’s immigration status unless the patient offers it up.

Lauren Collins-Cline, spokesperson for the center, says staff would handle an inquiry from ICE the same way they're trained to handle interactions with local or state police. "The concept of a sanctuary hospital is not something that has been discussed in terms of adjusting policy or forming a new policy. Our first priority above and beyond everything else is to ensure patient care."

But some physicians believe part of that patient care centers around making people feel safe.

Leila Haghighat, a resident physician at Yale New Haven hospital in Connecticut, says hospitals should be proactive about establishing sanctuary policies and getting the word out to the community.

"It would almost brand the hospital as such so that people could always remember in an emergency situation that there is not a barrier to coming into the hospital,” she says. “That this is a place that I can go to where I don't need to think about issues of immigration and deportation and that my health care comes first."

Haghighat believes it's important to put a policy in writing and advertise it to undocumented immigrants. Because in the current climate, she says, they may be afraid to leave their house.
