Since January, there have been almost daily media reports about federal government agents conducting operations intended to sweep up individuals who are in the U.S. illegally. The primary agency responsible for these activities is Immigration and Customs Enforcement (ICE). “ICE raids,” as they have come to be called, have caused a great deal of confusion and anxiety for health care entities, including clinical laboratories, who struggle to balance cooperation with law enforcement on the one hand, and respecting the right of their employees and patients on the other.

Historically, the concept of a law enforcement “raid” has arisen in the context of search warrants. Search warrants are judge-signed orders that allow agents to enter a particularly designated place to search for and seize a particularly identified thing or things. In the prototypical example of a search warrant raid, multiple dark vans or SUVs pull up in front of the laboratory site, numerous agents in bulletproof vests and jackets emblazoned with “FBI” pour out of those vehicles and rush into the building, causing panic as they charge into offices and storage rooms, grabbing technology and paper. If federal agents appear with a valid warrant, laboratory personnel cannot physically stand in their way. Any obstruction is likely to result in criminal charges.

As a result of policy changes by the new presidential administration, however, the “raid” concept that now comes to mind are “ICE raids.” ICE was created in 2003 in a merging of the investigative and interior enforcement elements of the former U.S. Customs Service and the Immigration and Naturalization Services. ICE is now a division of the U.S. Department of Homeland Security, and it has a budget of approximately $8 billion and workforce of roughly 20,000 personnel. Its scope of operations includes enforcement of the laws governing immigration, border control, customs, and trade. ICE Within ICE, the unit or “directorate” responsible for the recent “raids” is known as Enforcement and Removal Operations.

It is important to understand that ICE agents are essentially federal police officers. They are not the military operating unrestricted in a war zone. Like FBI agents, their powers are limited by the U.S. Constitution and federal law more generally. ICE agents usually appear with an administrative warrant signed by an immigration judge; these warrants do not grant agents the broad powers of a search warrant. Absent a valid search warrant signed by a United States District Court judge, ICE agents appearing with an administrative warrant or subpoena still generally need the consent of the laboratory to enter into private places to search for and take documents or property—or to seize individual persons. This raises some key questions about circumstances where there is no search warrant involved:

Do we have to let them come into our facilities? ICE agents have the right to enter into any part of a lab’s facility, like a waiting room, that is open to the general public. ICE agents are not, however, authorized to enter into any non-public areas within the facility without permission. Importantly, permission to enter private areas can be expressly given or even implied from circumstances, so it is important that lab personnel understand clearly which areas of the facility are public and which are private. It is critical that personnel know precisely what to say to explicitly decline an ICE agent’s demand to access a non-public area.

Do we have to answer their questions? Although ICE agents are free to ask questions about the lab’s operations, employees, and patients, there is no obligation to answer those questions. Additionally, protected health information (PHI) is protected from disclosure under HIPAA and a number of state laws, just as is personnel information about any of the lab’s employees. Again, it is important that personnel have been instructed how to respectfully decline to answer questions from agents.

Do we have to show them records or give them copies? As with questions seeking information, there is no obligation to produce documents for ICE’s review or seizure. Moreover, documentation with PHI and personnel information should not be made available to government agents without a subpoena or search warrant. Beyond that, when agents on are site, employees should take care not to have electronic or paper document in plain sight where they may be viewed by agents.

Should we physically stop ICE agents who are attempting, without our consent, to enter into a private area in the lab or to take documents or property? No. Any physical interference, particularly physical contact, with an ICE agent is likely to be met with an arrest and ensuing federal criminal charges.

The appearance of federal agents will be a stressful situation for almost all lab personnel. The stakes are high, so it is important to seek guidance from legal counsel in these situations. Nonetheless, it is also worthwhile to consider working with legal counsel to develop in advance a straightforward written policy for employees to reference at the moment ICE arrives on site. Such a policy would be designed to minimize anxiety while ensuring legally appropriate outcomes.