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Facts for Your Liason
On Interacting with Customs and Border Control
RELEASING PATIENT INFORMATION WITHOUT A JUDICIAL WARRANT IS A VIOLATION OF HIPAA, A LAW THAT ALL HEALTH CARE WORKS ARE BOUND TO FOLLOW
All healthcare teams are encouraged to develop a protocol to manage what to do if ICE officers come to your office. Below are key pieces of information your liaison may need.
WHAT IS A LIAISON AND WHY DO I NEED ONE?
Liaisons are people in your office who have additional information about managing interactions if law enforcement, ICE, or other officers come to your office and can ensure office security and patient privacy are maintained.
Healthcare offices and facilities have historically not been targets of these interventions, but this has changed in 2025. As such, liaisons need to be rapidly available during regular business hours, and staff knows how to quickly communicate with your liaison.
Please remember that ICE cannot interfere with medical treatment, even with a warrant.
PUBLIC VS PRIVATE AREAS
Public Areas
Public areas are those readily accessible to the public, such as waiting rooms, parking lots, or cafeterias. Please ensure all protected patient information is not in plain view and conversations are not in plain hearing of public areas. Enforcement agents are allowed to enter public areas without a warrant, and gather any information that is in plain sight or plain hearing.
Private Areas
Private areas are areas where patients are receiving care, or where there are standard restrictions on who is allowed in that area, such as office space and exam rooms.
Although enforcement agents may enter public areas, you are allowed to direct them to a different area so that operational factors, such as a crowded waiting room, which does not interrupt patient care.
Please review your office to ensure no private information is on display either in plain sight or in plain hearing, and privacy laws are being followed.It is a HIPAA violation to leave patient information in plain view or plain hearing, even inadvertently.
Clear signage designating specific areas for “office personnel, staff, and patients ONLY” can help differentiate private vs public areas.
WHAT ARE ADMINISTRATIVE AND JUDICIAL WARRANTS?
Under the law, ICE officers are only legally allowed to detain people or enter private areas with a judicial warrant signed by a judge.
Administrative Warrant
ICE may come to your office with an administrative warrant.
An administrative warrant is the most common type used by immigration enforcement officers that authorizes an officer to arrest a person suspected of violating immigration laws.
Administrative warrants can be authorized by an enforcement officer. An administrative warrant is not a warrant within the Fourth Amendment to the Constitution because it is not supported by probable cause of a criminal offense, and is not issued by a court judge or magistrate.
An administrative warrant is NOT ENOUGH to authorize violation of HIPAA. Do not give information about a patient or consent for ICE to enter private areas and do not take ICE to the person identified in the administrative warrant.
Judicial Warrant
A judicial warrant is a warrant signed by a judge or magistrate. It authorizes search or seizure of property, entry into a private place to arrest a person in a warrant, or arrest a person.
How can I tell the difference?
Your liaison should review the warrant carefully to determine the following
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​Is it administrative or judicial?
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Is it signed and dated by a judge or a magistrate?
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Is it being executed in the time period specified by the warrant, if any.
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What is the scope of the warrant? For example, if the warrant is for the emergency room, the warrant may not be used to search private exam rooms.
If ICE enters an area not in the scope of the warrant, voice your concern that this is beyond the scope of the warrant and document that you DO NOT GIVE CONSENT for ICE to enter that area.
You are encouraged to photocopy of whatever document is provided to you, to obtain identifying information for the individuals involved in the enforcement action, and what these individuals do.
EXAMPLES OF ADMINISTRATIVE VS JUDICIAL WARRANTS
WHAT IF THERE IS AN ENFORCEMENT ACTION?
Stay calm! Ask workers to stay calm too. Above all, liaisons and staff are to maintain safety and follow the rule of law. All employees should be polite and respectful to any enforcement agents.
Implement your previously practiced protocol, an example of which is below. In addition, please consider how you intend to do the following:
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Consider having a code to alert staff that immigration officials may be present and implement policies that you have developed for staff to follow under these codes.
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Ask that patients that are not involved in the enforcement action remain in their rooms with the doors shut until the situation has resolved.
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Ensure that as a part of your protocol, a second staff person is identified to contact legal services if needed and that your attorney’s information is easy to access.
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Enforcement officers should always be accompanied by a designated person, and this person should inform the officer if their actions are outside of the scope of their warrant.
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If you are working with children or individuals who rely on others for communication or basic care, please ensure that you have updated emergency contact information such that you can access supports for that individual if others are detained. If parents/caregivers are detained but not the child, staff should remain with the child until an emergency contact can be reached to come help the child. If you are unable to reach any emergency contacts, please contact the Department of Human Services.
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Make sure everyone knows who to contact when and knows their rights!
If ICE agents try to enter a private area without speaking to you, you may say: “This is a private area. You cannot enter without a judicial warrant signed by a judge. Do you have a judicial warrant?”
Clearly let the agent know that you DO NOT CONSENT to a search of private areas without a properly issued judicial warrant.
SAMPLE PROTOCOL
Inform the agent that you are not authorized to comply with any requests until your Liaison reviews the situation and any relevant documents.
Ask the agent to wait in a public are while you make the call
Call your liaison (or attorney or other relevant providers)
Staff should safely make sure ICE agents go to the designated public area.
Security or police can be engaged if they refuse to wait in the designated area.
Continue to prioritize clinical care. You can provide treatment to your patients. ICE cannot interfere with your treatment, even with a warrant.
If ICE detains anyone at your office, ask where these individuals are being taken. This will help the individual’s family and attorney find the person.
If ICE enters an area without a warrant, please document everything that happens thoroughly on paper or digitally in a format that is NOT a part of the medical record.
Include in this information:
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Photocopy of all legal documents presented
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Name and badge number of all enforcement officers
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How many ICE agents were present (inside and outside)?
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How were the agents dressed? How were they armed?
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​What did these agents do?
If ICE obtains patient information, please contact your attorney and follow their protocols around disclosure of patient information.
YOU HAVE RIGHTS
The right to remain silent. If you wish to exercise that right, say so out loud.
The right to refuse to consent to a search of yourself, your car or your home.
If you are not under arrest, you have the right to calmly leave.
The right to a lawyer if you are arrested. Ask for one immediately and exercise your right to remain silent until your lawyer is present.
Regardless of your immigration or citizenship status, you have constitutional rights.
The right to contact your consulate or have an officer inform the consulate of your arrest.
CHECKLIST FOR OFFICE LIASON
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I have identified and made readily visible the contact for our attorney to call in the event of enforcement action.
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Office staff have practiced what to do and say if there is an enforcement action.
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I have identified how any actions are documented and who will be doing the documenting.
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I have determined when and how patients should be informed if immigration enforcement enters the clinic.
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Ensure all staff are trained and have a chance to practice implementation of these protocols.​​
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I have reviewed public/private designations and adjusted signs as needed. I have reviewed and double checked that no patient information is in plain sight or plain hearing. I have developed a plan to regularly check to confirm these privacy practices are maintained.
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I have identified a local immigration attorney to help manage challenges if they occur
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I have considered options, and developed plans for their implementation, such as use of telehealth or home visits if patients are fearful of coming to the office due to enforcement presence or fears of enforcement presence.
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I have educated my staff about careful documentation and that immigration status is not a part of a health record. I have educated my staff about teaching patients that they are allowed to refuse to answer questions.
For more information
https://hiaspa.org/wp-content/uploads/2025/02/KYR-Package-updated-2_23_2025.pdf
In addition to the information listed below, we strongly encourage you to identify a local immigration attorney ahead of time to work with for if these situations happen.
Adapted from Immigration Law Center, California Attorney General Healthcare Access, HIAS Pennsylvania.
NOTE: The information in this document is not meant to provide legal advice or to substitute for the guidance, counsel or advice of legal counsel on any matters particular to a specific clinic. It is important that the clinic consult competent legal counsel to help determine when and to what extent the clinic is required to comply with administrative requests or whether a legal document has been properly issued. Also, please be aware that such designations do not guarantee that immigration officials will or must comply with those policies. In these circumstances the clinic would have the legal right to argue their case in court. In the case of a possible legal challenge, the health center should document as much factual information regarding what immigration agents did for the health center’s records.
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