Keeping Students and Families Safe: Healthcare Breakout Session Rose Community Foundation Form September 20, 2017 Arash Jahanian, Staff Attorney ajahanian@aclu-co.org (720) 402-3106

Words of Warning Modern Healthcare: “Tougher immigration enforcement is taking a toll on healthcare” (Apr. 21, 2017) http://www.modernhealthcare.com/article/20170421/NEWS/170429967

Words of Warning Patients, concerned that information is being shared with immigration authorities or that ICE will come to facility, stop coming in In addition, severe stress can lead to negative health effects

Overview of Patients’ Rights

Patients’ Basic Rights Right to remain silent Right to counsel (lawyer) Right to refuse searches without a warrant Right to contact consulate Regardless of immigration status, non-citizens in the U.S. generally have the same constitutional rights as citizens when law enforcement officers stop, question, arrest, or search them or their homes. However, there are some special concerns that apply to non-citizens. Everyone has these Constitutional rights, regardless of immigration status.

Patients: Right to Remain Silent If you wish to exercise your right to remain silent, say so out loud. You do not have to answer questions about where you were born, whether you’re a U.S. citizen, or how you entered the country.

Patients: Interaction with ICE Agent If not a U.S. citizen and agent requests immigration papers, must show them. If over 18, carry immigration documents at all times. If you don’t have immigration papers, say you want to remain silent. Do not lie about your citizenship status or provide fake documents. It is a crime and can be source of future criminal charge.

Patients: If Stopped in a Public Area Stay calm. Don’t run, argue, or resist. Ask if you are free to leave. Don’t consent to searches. Remain silent if you do not want to answer questions.

Private Area: Warrant Keep door closed and talk through it. Warrant must be signed by judge for them to enter (ICE warrant for removal/deportation will not be). Must also name person and/or areas to be searched, and right time period. Ask them. If they don’t have warrant signed by judge, you don’t have to let them in. If they say they have a warrant, ask them to slip the warrant under the door. Look at the top and at the signature line to see if it was issued by a court and signed by a judge.

Private Area: Warrant If immigration agents have an ICE warrant, you do NOT have to let them in. If they say they will get one, try to have lawyer present before the warrant is served or search begins. If they force their way in without warrant, don’t resist but say you don’t consent. You can ask: What reason do you have to target this individual? During the search, document the search with notes, photos, video.

Patients: If You Are Arrested by ICE Agents Don’t lie or present false documents. State that you want to remain silent. Do not sign anything without a lawyer. Right to remain silent Right to counsel (lawyer) Right to refuse searches without a warrant Right to contact your consulate Government will not provide a lawyer. Ask for list of free or low cost legal services. Contact your consulate, or ask an officer to inform them of your arrest. Know your immigration number (“A” number), and give it to your family to help them locate you.

Patient’s Plan Organize and keep important documents in safe place: Personal documents Immigration Documents Criminal Court Documents Keep list of important numbers, including family, consulate, immigration lawyer Decide who will take care of children, make decisions (Power of Attorney) if detained

Important Phrases “Are you detaining me, or am I free to go?” “I don’t consent to searches.” “I can’t let you in without a warrant.” “I want to remain silent, and I’d like to speak to an attorney.”

Applicable Law and Policies

Sensitive Location Both ICE and CBP consider healthcare facilities to be sensitive locations. Immigration enforcement actions are to be unless exigent circumstances exist or the officers have prior approval from certain officials within the enforcement agencies.

Disclosure of Information No affirmative legal obligation to inquire into or report a patient’s immigration status. HIPAA generally prohibits disclosure of patient information without patient consent, except where required by law. Under other exceptions, including when information is requested by law enforcement, personal health information may be shared, but its release is generally not required.

Denver’s Policies: City Ordinance Denver does not honor ICE detainers. Sheriff does provide notification of release “to the extent they are able,” but informs individuals of their rights. City employees are prohibited from collecting information on immigration status, sharing other information for purposes of immigration enforcement. Immigration enforcement officials are no longer permitted access to secure areas without legal justification. Ordinance 17-0940 passed August 21, 2017

Denver’s Policies: Executive Order Establishes legal defense fund. Establishes working group. Ensures equal access to all city facilities and makes information available in multiple languages. Executive Order No. 142 issued August 31, 2017

Possible Policies and Practices

Written Policy Designating Private Areas Establish written policy identifying which areas are closed to the public. Limit access to certain areas only to those who are receiving or providing care, or who are otherwise necessary – patients, family, essential medical personnel.

Waiting Room May be open to the public, but individuals must be invited to enter examining rooms, offices, and records areas. Alternatively, may be open only to patients and people accompanying them, while public must remain in areas outside the building. Consider cordoning off areas where patients receive treatment from public waiting rooms. Beware of what’s in “public view.” Be cautious of what information is in open view of the public, such as files visible from the visitors’ side of the reception desk.

Immigration Information Avoid asking for immigration status. If you must, avoid including that information in medical and billing records. Reassure patients of your practices and their privacy.

Educational Materials Know Your Rights Information in Reception, Waiting Areas (in different languages) Signs? Benefits presentations?

Your Staff Designate someone to handle all contact with law enforcement. Train all staff on your policies, patients’ right. Practice/roleplay responses to immigration raid. Train on cultural sensitivity E.g., “undocumented,” not “illegal”

Outside Contacts Establish relationships with immigration lawyer or have lawyer on board whom you can call. Consulate Colorado Rapid Response Team: 1-844-864-8341

Questions/ Discussion