ICE in the hospital: Quick response guide for frontline staff

Hospitals are increasingly encountering law enforcement officers — from local police to federal agencies such as Immigration and Customs Enforcement (ICE) and Customs and Border Protection (CBP) — within clinical settings, making it essential for frontline staff to understand how to respond while protecting patient rights, safety and privacy. These situations can be unexpected and stressful, but with clear protocols, staff can remain calm, uphold legal and ethical standards, and ensure that any interaction is handled appropriately and consistently.

This guide provides practical, step‑by‑step direction to help healthcare teams manage law enforcement encounters without compromising patient care or violating federal privacy regulations.

Definitions

• ICE (U.S. Immigration and Customs Enforcement): A federal law enforcement agency that enforces immigration and customs laws under the Department of Homeland Security
• CBP (U.S. Customs and Border Protection): The federal agency responsible for securing U.S. borders and regulating entry of people and goods, also under the Department of Homeland Security
• DHS (U.S. Department of Homeland Security): The federal executive department responsible for public security, including immigration, customs and border control

Guide

Your goals: Protect patient care and privacy, stay calm and immediately involve the designated hospital leader.

1. 01

   If ICE/CBP agents appear at your unit

   • Be calm, respectful and non‑confrontational; don’t argue or obstruct
   • Ask who they are and why they are there: Name, agency and to see identification
   • Don’t provide any patient information, confirm a patient’s presence or grant access to clinical areas
   • Explain that you don’t have the authority to answer questions or grant access, but that you will contact a hospital representative (“I’m not authorized to answer questions or grant access. I will contact our hospital representative now.”)
   • Tell agents to remain in public or administrative areas (lobby, main hallway) until leadership or a representative arrives

2. 02

   Call and escalate

   • Charge nurse and attending physician or hospitalist
   • Administrator on call or designated ICE liaison
   • Security if needed for crowd control and safety (not to confront agents)

   Don’t take independent action or make any exceptions.

3. 03

   Warrants and access

   Only the designated hospital leader or legal professionals may review any documents.

   Key considerations:

   • Judicial warrant that is signed by a judge or magistrate may allow limited access as specified
   • Administrative warrant (signed by ICE or DHS only) does not give authority to enter non‑public areas or access patients or their records
   • Without a valid judicial warrant or court order, the hospital generally may decline access to patient care areas and to the patient’s private health information

   If asked to escort them to a room or workstation, say: “I can’t do that. You’ll need to speak with our hospital representative.”

4. 04

   Patient care and communication

   • Emergency Medical Treatment and Labor Act (EMTALA) and ethics: Treat and stabilize all patients regardless of immigration status
   • You may tell patients, in general terms (“You don’t have to speak with ICE and you have the right to remain silent and to talk with a lawyer.”) but don’t give individual legal advice
   • If ICE plans to detain or remove a patient, the physician should document whether discharge or transfer is medically safe and advocate to delay if it would jeopardize patient health

   Avoid documenting immigration status unless required for a specific program.

5. 05

   Documentation by staff

   • Note date, time, location, agents’ names, agencies and badge numbers
   • Record what was requested, what documents were shown and who from the hospital responded
   • Follow hospital policy for any recordings or incident reports

Resources

1. The Trump Administration’s Immigration Enforcement Policy: What Hospitals and Health Care Providers Must Know for Their Patients and Visitors [Video]
2. Health Care Providers and Immigration Enforcement: Know Your Rights, Know Your Patients’ Rights
3. Greater New York Hospital Association
4. Loyola University Resources
5. The Hospitalist
6. ONA – Ohio Nurses Association