By Tim Stewart, Jarrard Inc. Partner and Academic Health Systems Practice Lead
Among the initial wave of executive orders and signals of intent from the Trump administration, the announced plan to remove protections that bar Immigration and Customs Enforcement (ICE) from pursuing raids in hospitals has created a great deal of uncertainty for health systems across the country.
Some of this ambiguity is no doubt strategic on the part of hardline immigration reformers within the administration. While opening up the potential for aggressive immigration enforcement is not a guarantee of actual enforcement in your hospital, it does guarantee that the undocumented immigrants in your community must add layers of risk assessment to their already-fraught everyday experience. This group may become even more inclined to ignore non-emergent healthcare issues until they become emergent, which is not in their or the health system’s interests.
In the absence of clarity about what comes next, hospitals can cautiously create some pockets of certainty by defining what you control and how you act. That decision tree starts with asking the right questions:
- What are our existing policies and procedures and what do we need to do to clarify them for our people?
- What does the state and local immigration landscape look like? And do we anticipate state regulatory or legal action on this issue?
- What are the potential impacts for our workforce, including foreign visa workers?
From there, the baseline for responsible communication to your workforce and community becomes emphasizing legal, factual guidance on how to handle potential visits from ICE, consistent with existing organizational policy and state and federal law. It’s also worth affirming your commitment to treating all patients who walk through your doors. The mission to serve patients is not dependent on administrative action or any outside force.
If the needs of your community call for an escalated response, you may also determine that this is a good moment for your hospital to learn how to essentially speak in code. Leaders in improving social determinants of health are well versed in this sort of code construction. They focus their work on things like improving maternal health outcomes for all patients, knowing that, based on the data, success in that work will disproportionately improve outcomes for mothers in marginalized communities.
So, what could that code look like in this context? Perhaps it’s time to revisit your mid-2020 digital marketing campaigns detailing your wide range of virtual care options. This care is available to everyone but will also speak directly to the concerns of people who might be inclined to put off in-person visits. You may also choose to update your wayfinding signage to emphasize the location of private patient areas of your facilities.
In an uncertain environment, people are looking for clarity. While you cannot guarantee that immigration enforcement won’t happen within your facilities, you can responsibly equip your team members and patients to both comply with the law and deliver care to the best of your abilities.
