NEW YORK − The man Dr. Gray Ballinger treated Wednesday for high blood pressure delayed care out of fear of immigration enforcement, the Queens primary care physician said. The man, whose wife has stage 4 cancer, isn’t alone in his anxiety, Ballinger said.
“People’s blood pressure is much higher than usual on a regular basis,” Ballinger, who uses they/them pronouns, told USA TODAY. “The sense of fear in Queens among immigrants is heartbreaking.”
Many in Ballinger’s hospital − which serves a high immigrant population in one of the most diverse regions in the U.S. − have worried about threats of raids by Immigration and Customs Enforcement agents. Officials in New York City have tried to present facts and dispel myths circulating online about ICE actions, though that hasn’t eased concerns.
As President Donald Trump fulfills his campaign promise to deport immigrants with criminal records, he also has rescinded a ban on targeting sensitive areas, such as hospitals, schools and churches. Noticeably fewer people are entering waiting rooms, schoolyards and mosques, community leaders say.
Immigrant rights advocates have decried what they call an erosion of rights to basic services.
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“This has never been about safety and security,” Murad Awawdeh, president and CEO of New York Immigration Coalition, said at a rally Thursday at St. Mark’s Episcopal church in Manhattan. “This is about the cruelty.”
Some clinics say their waiting rooms are empty
In Manhattan’s Hell’s Kitchen neighborhood, Ryan Health clinic has had a drop in its waiting room since Trump took office, said Hugo Roman, a patient services representative at the federally qualified health center and a member of SEIU 1199, a labor union for health workers. The clinic has recently served the influx of asylum seekers to New York, but fewer people are making appointments.
Clinic and hospital staff, with guidance if or when ICE arrives for someone, are now trying to navigate patient rights with judicial warrants for agents to arrest someone. ICE did not respond to a request for comment when asked about actions in health facilities. Immigration experts and lawyers USA TODAY spoke with said it’s unlikely ICE would target people in settings such as schools, hospitals and churches.
Days before Trump took office, New York City officials released guidance instructing staff at public hospitals about what to do if ICE enters their facilities. The memo by city Health + Hospitals, obtained by USA TODAY, included information on contacting immigration liaisons, as well as making copies of warrants or subpoenas.
The memo also noted: “Please note, it is illegal to intentionally protect a person who is in the United States unlawfully from detention. You should not try to actively help a person avoid being found by ICE.”
Ballinger, who is at the Queens public hospital, received the same memo. They said providers must obviously follow the law, but it raises concerns about how doctors and nurses care for patients.
“We are on a shifting ground,” Ballinger said. “We’re not really sure how this would apply to patients who are in a critical scenario.”
For example, Ballinger said, what about a patient on a ventilator, or a woman in labor or who just gave birth to a child?
“Fundamental to a physician-patient relationship is the fact that the patient feels like they are safe with me,” Ballinger said.
On Thursday, New York City and state officials gathered at Kings County Hospital in Brooklyn to protest the public hospital directive. In a statement, state Sen. Zellnor Myrie, a candidate for mayor, said the guidance could “intimidate people” and prevent them from seeking lifesaving care.
City officials said in a statement that they encouraged patients to seek care before they have a serious illness or emergency.
“Our focus is always on the safety of our patients and employees,” the Health + Hospitals statement said. “The policy we sent to all staff sets forth clear and understandable steps to take if an enforcement agent enters the facility, and it ensures the safety of our staff − who are on the frontlines every day − by making sure they understand the law.”
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A ‘gloves off’ approach
Seth Chandler, a foundation professor at University of Houston Law Center, said hospitals are having to navigate the “new gloves-off immigration enforcement” and traditional hospital regard for patient privacy and having an orderly hospital.
Reviewing the New York City document, Chandler said officials are looking to get a basis for ICE being at the facility. It is sound advice not to harbor or conceal a person unlawfully present in the U.S., which is a federal crime, he said. Staff also must comply with the federal Health Insurance Portability and Accountability Act, or HIPAA, that protects personal health information without a patient’s consent.
“There are going to be close cases in which hospital personnel have to decide whether HIPAA gives enough shield to tell the ICE agent, ‘I’m not going to tell you whether that person’s here, and I’m certainly not telling you what room they’re in,’” he said.
Providers will have to take a risk standing on HIPAA, he said. “On the other hand, the hospital might well be right. They may well win if they are prosecuted, but no hospital wants to go down that path.”
Still, he said, sensitive areas like hospitals aren’t likely areas where ICE actions will occur, given that people probably wouldn’t hide in hospitals, and immigrants without lawful status tend to not frequent hospitals anyway.
Caring for well-being, not immigration status
In the Chicago suburbs, Lia Kim-Yi, director of immigration law practice at the North Suburban Legal Aid Clinic, said institutions like hospitals or churches need to remind people of protections afforded to people under federal and local or state laws. For example, not seeking medical care can lead to permanent damage.
“They care about your well-being, not your immigration status,” she said.
Still, for mothers like Monica, 35, everything from who picks up her two U.S.-born children from school to medical appointments takes planning and caution.
Monica, who declined to use her last name for fear of immigration enforcement, is part of Deferred Action for Childhood Arrivals, the Obama-era program granting temporary work visas from deportation. Even though she has been in the country for 29 years, she has no path to citizenship until her eldest, 11 years old, turns 21.
For now, DACA is protected, though Trump tried to end it in his first term. He already has cut programs such as temporary protected status.
Her children overheard her conversation on immigration during work at a nonprofit.
“Their next question was, ‘Are you in danger?’” she told USA TODAY in the upper pews of St. Mark’s Episcopal church Thursday in Manhattan. “Not for now,” she told them.
Her children asked who else is in danger, and she went down a list. They could be put in a detention center, or sent back to their home country.
“But our objective is not to find out,” she said. “Our objective is to be as cautious as possible. To avoid that.”
