The Trump Administration has overturned policies that banned immigration enforcement in “protected areas,” including health care facilities such as hospitals, doctor’s offices, and clinics, and directed federal agencies to prioritize immigration enforcement.

In December 2024, California Attorney General Rob Bonta issued updated guidance for health care facilities summarizing relevant legal considerations and policy recommendations when responding to immigration issues. The guidance consists of three sections, as well as several appendices. Section 1 (starting at page 4) describes legal requirements and restrictions on the collection and retention of patient information, including immigration status. Section 2 (starting at page 9) discusses laws governing the disclosure of patient immigration status data, and other patient data generally, to law enforcement. Section 3 (starting at page 17) explains legal protections and requirements for law enforcement requests for physical access to health care facilities or patients or access to patient data for immigration enforcement purposes, including legal requirements and limits for various types of warrants and subpoenas.

Physician practices should consider developing protocols (or reviewing and updating existing policies and procedures) for collection and retention of patient data, including patient immigration status, and for responding to immigration enforcement visits and requests for access, as well as training staff on any new protocols in advance. Practices should consult with an attorney on developing or updating these protocols, as well as when faced with a request by an immigration enforcement officer for physical access to a practice site or patient, or access to data on patients or their families, to ensure compliance with HIPAA, CMIA, and other applicable state and federal laws.

Physicians practicing in facility settings should also familiarize themselves with the facility’s policies and procedures on immigration law enforcement actions, and notify the designated health care facility administrator of any request by an immigration enforcement officer.

The California Medical Association will share additional guidance and resources as they become available.

For more information, see “Promoting Safe and Secure Healthcare Access for All: Guidance and Model Policies to Assist California’s Healthcare Facilities in Responding to Immigration Issues.”