Legal Action Center Publishes Guide for SUD Tx providers for Responding to Immigration Enforcement

In January 2025, the Department of Homeland Security (DHS) rescinded guidance that previously limited immigration enforcement actions in “sensitive locations,” including healthcare settings. This announcement has sparked concerns and uncertainty among many, including staff, patients, and participants at SUD treatment and harm reduction programs.

The Legal Action Center released "Responding to Immigration Enforcement: A Guide for Substance Use Disorder Treatment Programs" to help providers navigate patient privacy protection amidst changes to immigration enforcement policy. The guide highlights the particular legal and practical issues for programs covered by the federal privacy law for SUD treatment records, 42 USC 290dd-2 and 42 CFR Part 2. Staff can use the guide to prepare for potential immigration enforcement actions, provide accurate information to patients, and understand their legal obligations to maintain patient confidentiality.

The guide outlines practical steps for SUD treatment programs to protect both clients and staff. Recommended actions include avoiding collection of immigration status information, minimizing patient time in public areas, clearly marking non-public areas, training staff with scripts and protocols, and designating specific personnel to handle warrants or legal inquiries. Staff are advised to never voluntarily disclose patient information, to document all law enforcement encounters, and to provide patients with know-your-rights materials. Importantly, staff should not assist patients in evading immigration authorities but can inform patients of their right to remain silent. Programs are also encouraged to build clear internal policies and conduct regular training refreshers to ensure legal compliance without escalating conflicts during enforcement visits.

For further guidance, programs are directed to resources such as the Legal Action Center’s sample scripts and their "Letter to Law Enforcement" regarding 42 CFR Part 2 protections. Programs can also refer patients to materials from the Immigrant Legal Resource Center and local nonprofit organizations that offer immigration legal support. Ultimately, the guide stresses that maintaining strong confidentiality practices and knowing legal rights are essential not only to protect patients but also to preserve the integrity and mission of substance use disorder treatment programs serving vulnerable communities.