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Federal immigration officers have behaved in “highly unusual” ways when guarding detainees receiving treatment at Legacy Emanuel Medical Center, potentially undermining patient privacy and care, the Oregon Nurses Association alleged in a letter Thursday.
The document raises questions not just about federal agents’ conduct, but about inconsistencies in a major Portland health system’s policies and practices regarding federal immigration officials on its grounds—“particularly,” the union says, “when compared to the clear, established protocols used with other law-enforcement agencies.”
Legacy shot back in a statement, saying the union’s letter was misleading, and that the health system takes patient health, safety and privacy extremely seriously and follows all state and federal laws that regulate the access and disclosure of protected health information.
Legacy directed questions about law enforcement practices to U.S. Immigration and Customs Enforcement. Neither ICE nor its parent agency, the U.S. Department of Homeland Security, responded by end of day to questions sent Thursday morning about the allegations.
The hospital said it received the letter from the union late Wednesday. The union on Thursday morning made that letter public.
Citing reports from nurses and other staff, the union alleges hospital administration has failed to manage behaviors by federal agents that it says not only put hospital staff at legal risk, but threaten patient privacy and medical care and seem to diverge from the hospital’s written policy.
The union says part of the problem is Legacy has failed to provide clear lines of authority and decision-making. As a result, its letter said, nurses “are reporting day-to-day practices that depart sharply from those written commitments, confusion and differing standards for different law enforcement agencies, and ultimately the placing of nurses at risk of breaching statutory protections because of Legacy’s unwillingness to clearly identify when disclosure of [protected health information] to law enforcement is allowed. These practices place patients and nurses at risk, both clinically and legally, and create a climate of fear and moral distress.”
For example, the union says hospital policy makes a clear distinction between public and nonpublic areas, and puts certain restrictions on where law enforcement may go without management approval. And yet the union says it received reports of federal officers “roaming halls and units, rather than remaining strictly with their detainee,” and “clustering around patient rooms and emergency department bays.”
According to the union, Legacy’s systemwide communications have indicated that law enforcement detainees at the hospital retain the legal right to have their medical privacy protected, but this principal has been violated in practice.
The union says it has received reports that “ICE officers have been allowed to remain at the bedside of ICE detainees at all times, including during sensitive exams, mental health assessments, and bathroom use,” and “refused to step away even when nurses or providers request privacy for clinically appropriate reasons.”
The union also raised concerns regarding the feds’ effect on medical care rendered to detainees. The union says federal officers have “reportedly pressured nurses and physicians to skip assessments, tests, or monitoring in order to move patients out more quickly.”
The union also says it has received reports of instances where physicians have “recommended continued hospitalization, but ICE insisted on removing the patient, effectively forcing discharge over clinical advice.”
Legacy vigorously rejected not only the allegation that it has applied policies inconsistently to federal immigration enforcement, but also the union’s broader framing of the situation.
In a statement, the hospital system says the union letter will create fear and confusion that will cause patients to delay emergency room care.
“We are also concerned that this gives the incorrect impression that we have experienced a substantial increase in law enforcement, including ICE, in our facilities, which is not true,” the hospital statement says, adding, “We have not had any law enforcement officers come to our facilities for enforcement actions.”
Asked about the time period the union letter refers to, ONA spokesman Peter Starzynski said, “From what we have heard, it’s been happening for a couple months.”
He says he does not know how many ICE detainees have been brought to Legacy Emanuel Medical Center in recent months. “We have heard it’s weekly, if not more,” he says, “But I do not know for how long it has been weekly.”
Asked if the union could facilitate an interview with a nurse familiar with the situation, Starzynski says nurses are reluctant to speak on the issue.
This is not the first time Portland medical workers have alleged federal agents have disrupted medical care with behavior that crossed the line.
As WW has reported, ICE agents took a patient to Legacy Emanuel on the night of Oct. 5, following an incident at the ICE facility on Portland’s South Waterfront.
Earlier that evening, two ambulance drivers later reported to their union and employer that a federal agent threatened to shoot them as they tried to depart with a patient they had been called to the facility to treat.
After the ambulance crew rebuffed federal agents’ efforts to ride in the ambulance, saying they could follow along instead, a crew member wrote that agents ultimately trailed the ambulance to Legacy Emanuel Hospital, where the patient was deposited.
According to the new union letter, two days later, on Oct. 7, Legacy disseminated among staff a document—“ICE Questions & Answers.”
The union says the document contained information on patient privacy, the division between public and nonpublic areas, the limited circumstances under which patient health information may be shared, and the role of security and management as the primary liaisons with law enforcement.
The union says these written policies were generally appropriate. The problem is, the hospital has not consistently followed the policies in practice, the union says, and has failed to provide clear lines of authority and decision-making when federal immigrations officials arrive.
The union says it has called for immediate corrective action by Legacy.
After the report on the Oct. 5 incident with the ambulance, WW reached out multiple times in October to Legacy officials to inquire about the conduct of federal immigration officials at Legacy Emanuel Medical Center.
At first, the hospital system did not offer a substantive response. In response to a later query, Legacy Health said in a Oct. 27 statement that it is “committed to providing safe, respectful and high-quality care to all patients, including those in law enforcement custody. Our guidelines and policies are designed to protect patient privacy, support our staff and ensure all interactions with law enforcement are handled with professionalism and respect, while complying with state and federal laws.”
