ICE in Hospitals: How Medical Legal Partnerships Could Help

Across the United States, immigrant patients and their families are increasingly facing a harsh reality: Immigration and Customs Enforcement (ICE) agents are appearing near or even inside hospitals. For those already carrying the heavy burden of illness, the compounding fear of detention or deportation is not just cruel — it is a barrier to care.

Despite legislative proposals to keep ICE out of hospitals, agents continue to come between patients and their health care. Ranging from detaining patients at hospitals to listening in on conversations between patients and health care workers, ICE is increasingly targeting immigrants in need of care. In other instances, enforcement actions led patients to delay or avoid care altogether. This chilling effect disproportionately impacts undocumented communities already facing health disparities.

As hospital policing intensifies, specifically targeted at undocumented immigrants as part of President Trump’s agenda, medical-legal partnerships (MLPs) might be able to complement existing efforts to support immigrants by helping patients and health care workers understand their rights in light of ICE entering the health care system. 

Funded by legal and health care organizations, MLPs embed lawyers in health care settings, where they specialize in helping patients navigate social and legal determinants of health. Situated in hospitals or community health centers, these attorneys assist patients in resolving their unique health care issues. For instance, after Eric Campbell’s blood sugar spiked, his physician arranged a meeting between him and the lawyer on staff at Whittier Clinic, who discovered a clerical error that helped him recover his food benefits and stabilize his condition. Similarly, after an eviction notice forced a patient at the University of Nebraska Medical Center to cancel her mastectomy for fear that she would have no place to recover, a lawyer at the Center helped her successfully fight the eviction. 

Today, approximately 450 MLPs operate in hospitals and health centers across 49 states and Washington, D.C., up from 270 in 38 states a decade ago. Their impact is demonstrable. In a single year, MLPs collectively helped more than 75,000 patients resolve legal issues directly tied to health, from unsafe housing to insurance denials. Studies show that between 50 and 85 percent of patients at health centers experience unmet legal needs that impact their health. The demand for MLPs is apparent.

Recently, MLPs have begun to specifically assist immigrants in hospital settings. The Yale New Haven Medical-Legal Partnership (MLP) has played a crucial role in helping immigrant families better prepare for detention and deportation. Their efforts ultimately led to the development of the Connecticut Family Preparedness Plan, a comprehensive document that guides families through the steps they can take to prepare for immigration enforcement. The Yale/Yale New Haven MLP and other similar initiatives can be viewed as concrete examples of how to continue to help immigrant families during Trump’s aggressive deportation agenda. 

MLPs have long understood that health extends beyond medical care — it encompasses a safe place to live, healthy environments, nutritious food, and other social determinants of health. ICE entering hospitals deeply threatens these bedrock necessities for living a healthy life, while also creating a climate of fear that affects immigrants’ willingness to actually visit care centers, fearing that they will be deported. In the context of ICE hospital encounters, MLPs could:

• Train staff on patient rights. Providers and administrators often don’t know what to do when ICE appears. MLP attorneys can educate hospital teams on when and how ICE requires warrants, what rights patients have, and how to respectfully yet firmly enforce those protections.
• Develop protocols. Just like hospitals have fire drills, they need clear, rehearsed protocols for immigration enforcement encounters. Legal partners can craft these policies to ensure that front desk staff, nurses, and security personnel all know how to respond.
• Support patients and families. MLPs can help patients complete legal paperwork (like advance directives, guardianship planning, or immigration relief applications) so they are less vulnerable if ICE acts.

• Advocate system-wide. MLPs can push hospitals and health systems to adopt “safe zone” policies, which affirm that immigration enforcement officers are not permitted in patient care areas without a judicial warrant.

Furthermore, MLPs could help families create important care plans if parents are detained and the child is not. Undocumented parents of U.S.-born children with disabilities, like Jorge Zaleta in Oakland, live with the fear that deportation could leave their children without care or guardianship. While the children qualify for medical and educational services, their parents face financial strain, limited legal protections, and long waits for residency relief. Medical-legal partnerships could play a critical role by helping families prepare guardianship plans in case parents are forced to leave or are detained indefinitely.

By embedding legal advocates directly into health care teams, MLPs could offer providers and patients the tools to push back against intimidation, protect their rights, and maintain a safe health care environment. 

However, MLPs face significant challenges. Despite funding from well-resourced organizations like the American Bar Association and the American Medical Association, MLPs continue to struggle with staffing limitations. Many operate with a sole attorney already burdened with managing dozens of patients with complex needs. Additionally, many MLPs struggle with navigating Health Insurance Portability and Accountability Act (HIPAA) compliance. Some clinicians are frustrated by the difficulty of referring patients to legal counsel while maintaining their privacy rights. Even when they finally get in touch, some lawyers report mistrust from patients who initially perceive them as bill collectors or spam callers. 

While MLPs are growing, more are needed to fill in the gaps, especially as complex immigration issues associated with ICE in hospitals continue to mount. Every patient — regardless of their citizenship status — deserves care without fear.