LA County policy expands immigrant patient rights. Hardly anyone knows about it

This story first appeared on The LA Local.

After widespread reports last year of immigration agents interfering with patient care and privacy at local hospitals, Los Angeles County now has a policy that asserts the rights of detained patients and instructs county public hospital staff on how to handle the ICE agents that accompany them. 

The policy, which went into effect in March, clarifies that patients brought in by civil law enforcement officers, including immigration agents, have the right to communicate with family members, legal counsel and advocates. Implemented by the LA County Department of Health Services, the policy has been described as a “new gold standard of care” meant to safeguard patient rights as hospitals navigate an influx of federal immigration raids.

There’s one problem, though: Hardly anyone knows about it. 

To physicians and advocates with the People’s Care Collective, a network of health care workers and organizers, this policy marks a major shift in how hospitals handle patients in immigration custody. But they said awareness of it has been lacking within the health care system, even though the Department of Health Services said the policy has been shared with staff. 

“The vast majority of the [LA County Department of Health Services] workforce, which is the second largest health care system in the country — second only to NYC — is unaware of this policy, unaware of all of the rights of their patients under this policy, and how the policy empowers health care workers to protect these rights,” said a Department of Health Services physician who is a member of the People’s Care Collective. The doctor asked to speak anonymously due to fear of retaliation.

The policy follows a Los Angeles County Board of Supervisors directive requiring the Department of Health Services to develop guidelines allowing patients detained by immigration authorities to authorize the release of information to family, counsel and government representatives. 

The policy also:

• Instructs staff to ask agents to remain outside of a patient’s room at all times, absent safety concerns
• Forbids unnecessary restraints, or shackling, of patients
• Requires agents to remain in public areas of the hospital unless they have a judicial warrant
• Requires agents to “remain identifiable at all times”
• Prohibits agents from acting as interpreters or surrogate decision-makers for detained patients
• Instructs staff not to physically interfere with ICE agents or assist a patient in hiding or fleeing
• Prohibits discharging the patient back into immigration custody “until custody is confirmed as lawful and documented.”

You can read the full policy here. 

These new guidelines only apply to public health care facilities and not private hospitals such as Adventist White Memorial in Boyle Heights, where doctors last year reported ICE agents violating the privacy rights of detained patients and prohibiting contact with patients’ family members. 

This article was published in collaboration with LAist.

People’s Care Collective members say they hope private health care facilities adopt similar measures — and they may have to if the state legislature passes several bills making their way through the legislature. But first, the members say, an education campaign is crucial to inform hospital workers and the public at large about the new guidelines.

“Being upfront about this really can set the precedent for places across the country to follow suit,” the LA County Department of Health Services physician said. “It’s our patients’ rights to know these rights. If we really care as a county that wants to live by our values [of caring] about all of its residents, including immigrant residents and folks who are being targeted by ICE, we need to walk the walk.”

The physician said members of the collective, who were aware of the Board of Supervisors’ directive, learned about the policy’s implementation last month only after searching through the Department of Health Services’ internal website. The department officially announced the policy a few days later by summarizing key points through email, according to the physician.

“The majority of health care workers are only going to know about the policy to the extent that is shared with them … and are not going to have the time and capacity to be digging deep into this internal website, finding the policy, reading it through [and] understanding it,” the physician said.

While health care facilities may fear retaliation by the Trump administration for being vocal about the rights of patients and immigrants, the physician said the Department of Health Services should “model the bravery and integrity” that its workforce has embodied since the beginning of the raids.

“These rights are not up for negotiation. They’re not flexible pending political circumstances,” the physician said.

A statement provided by the Department of Health Services said the policy is accessible to staff through a workforce portal, adding that a “guidance tool” has been distributed.

“We have also taken proactive steps to communicate this specific policy to all staff, supervisors, and managers through multiple internal channels, including all staff emails, hospital newsletters,” the statement said.

None of the hospitals or medical centers operated by LA Health Services have received a patient under civil custody, including ICE detention, since January 2026, according to the department.

This article was published in collaboration with LAist.

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J.W. Hendricks

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The LA Local

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Rebecca Trotzky-Sirr, a physician at LA General who has worked closely with patients in criminal custody, said hospitals across the country were caught off guard when the Trump administration’s aggressive immigration tactics led to an influx of patients brought in by ICE for emergency care. Many hospitals, including LA General, have clear protocols for handling patients in criminal detention, for example, after being arrested by a police officer. 

But most patients accompanied by ICE are civil, not criminal detainees.

“It took a long time for people to understand that,” she said. Trotzky-Sirr spoke with LAist as an individual physician, not on behalf of the Department of Health Services or LA General. 

Initially, she said, many health care workers assumed ICE had the same authority as criminal law enforcement agencies in medical settings to take precautions like restricting a patient’s communications.

“But that’s not what we should do," she said. "That’s not what we’re legally obligated to do.”

Plus, Trotzky-Sirr said, hospital staff, like anyone, might feel intimidated by a masked, armed agent.

“It’s hard to stand up confidently to someone with a gun,” she said. 

But staff members’ deference to the demands of federal immigration agents over patients’ rights  has been slowly changing, the doctor said, as more staff become educated on policies for handling detained patients, and especially, the difference between patients in civil custody versus criminal custody. Most patients who have been apprehended by ICE are civil, not criminal detainees.

“It took a long time for people to understand that,” the doctor said.

To Henry Perez, executive director of InnerCity Struggle, the county can strengthen awareness by working with organizations “with deep roots in the community.”

Perez, who has been involved in community efforts to protect patient rights at White Memorial, thinks of the county’s outreach work around housing and renters’ rights, partnering with organizations like Legal Aid Foundation of Los Angeles, Public Counsel and InnerCity Struggle. 

“There is a roadmap … and the county needs to reproduce that template that they already know how to do,” Perez said. “Just as housing is a critical issue in the community, so are immigrant rights and protections.

“A policy is only as good and as strong as its implementation and enforcement.”

Some Southern California legislators are trying to safeguard the rights of detained patients at the state level. State Sen. Caroline Menjivar, who represents Burbank and the San Fernando Valley, authored a bill, SB 915, that would, among other measures, prohibit immigration officers from remaining at a patient’s bedside unless there’s a credible risk of harm, or the officer has a valid judicial warrant.

A second bill, SB 1323, authored by state Sen. Susan Rubio, whose district stretches from El Monte to Ontario, would require hospital staff to immediately notify management when immigration agents show up. It would also require hospital management to instruct staff on how to respond to a detained patient’s request to notify family of their whereabouts. 

Both bills would apply to all health care entities in California, both public and private. 

The Department of Homeland Security did not respond to a request for comment by publication time. This story will be updated if a response is received.

This story was done in collaboration with Jill Replogle, reporter for LAist.