Protecting Health in a Time of Fear: What NH Providers Need to Know About Immigration and Care
Protecting Health in a Time of Fear: What NH Providers Need to Know About Immigration and Care
In today’s shifting policy landscape, understanding the intersection of immigration status and health is more critical than ever. Recently the New Hampshire Public Health Association hosted a webinar as part of its Policy Pulse series, focused on the real and growing challenges facing immigrant communities in New Hampshire—and the responsibilities of healthcare providers navigating this complex environment.
The session, Immigration Status, Policy, and the Impact on Health in New Hampshire, brought together over 80 public health professionals, healthcare workers, and advocates for a timely conversation on how federal and state policies are impacting immigrant access to care. With expert presentations from Katherine Harake of the ACLU of New Hampshire and Iraida Muñoz, Public Health Strategist for the City of Nashua, the training offered both practical guidance and heartfelt testimony on why this work matters.
See the Event Here
“This Is About More Than Law Enforcement. It’s About Community Resilience.”
NHPHA’s Executive Director Tory Jennison opened the session with context: under the Trump administration, immigration enforcement has intensified across the country and here in New Hampshire. Local law enforcement in some communities has taken on expanded roles in collaboration with ICE, including through the controversial 287(g) program. “These changes have led to fear in immigrant communities,” Jennison explained. “We’re seeing people delay or avoid necessary medical care—leading to real health consequences, from preterm births to untreated chronic conditions and mental health crises.”
She emphasized that about 15% of New Hampshire’s immigrant population is estimated to be undocumented, and that the vast majority of immigrant residents are working-age, English-proficient, and active contributors to the state’s economy and communities. “This is about more than law enforcement,” Jennison said. “It’s about community resilience and dignity.”
Know Your Rights: Inside the Clinic, On the Front Line
Katherine Harake of the ACLU NH delivered a compelling overview of what healthcare facilities need to know when interacting with immigration enforcement officials.
“The key distinction is between public and non-public spaces,” Harake said. “Waiting rooms and lobbies are public, but beyond that, you can define what parts of your facility are off-limits without a warrant. A simple sign can make a big difference.”
Harake walked attendees through best practices, including:
Designating a staff liaison to handle law enforcement interactions.
Verifying warrants and credentials—especially ensuring any ICE or CBP requests are signed by a judge.
Training all staff, from reception to clinical teams, to know their roles and understand HIPAA obligations.
“If you’re unsure, you don’t have to give information,” she stressed. “Silence is not illegal. It’s better to protect patient privacy than to disclose something you can’t take back.”
She even shared an analogy that resonated with attendees: “Think of law enforcement like a vampire—they can’t come in unless you invite them. And the only legitimate ‘invitation’ is a warrant signed by a judge.”
Stories from the Front Lines: Nashua’s Experience
Iraida Muñoz brought the policy conversation to life with personal stories and local insights. The former Equity Officer for Nashua’s public health department and an immigrant herself, she spoke candidly about the layers of barriers immigrant families face.
“In Nashua, we see it every day—parents who can’t advocate for their kids because of language barriers, or a mother who avoids seeking help for her child’s autism because she’s afraid of what it might mean,” Muñoz said.
She shared data and stories of children needing medical help that only came to light because a teacher or neighbor intervened. She also detailed the local advocacy effort that helped defeat House Bill 392, which would have dismantled the state’s Office of Health Equity. “Losing that office would have meant losing access to interpreters, culturally appropriate care, and support systems for vulnerable communities,” she said. “And we fought to protect it.”
Muñoz reminded attendees that many immigrants in New Hampshire are legally present, working multiple jobs, and raising families in the same neighborhoods. “They are your neighbors, your co-workers, your community members,” she said. “They deserve the same compassion and dignity as anyone else.”
Why It Matters — and What’s Next
This session highlighted how fear and policy confusion can create real health disparities. But it also offered a path forward. Providers and advocates now have practical tools to ensure clinics and hospitals protect patient privacy and respond appropriately to enforcement actions.
The webinar closed with a call to action: create protocols, train staff, and speak up for systems that protect everyone, regardless of immigration status.
As Jennison noted, “Our hope is that this helps providers serve with clarity, compassion, and confidence—so that all people in New Hampshire can access the care and dignity they deserve.”
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Follow-Up
Have questions about the “ICE Factor”? Katherine Harake is available to speak one-on-one with attendees. Reach out to the ACLU.