Hospitals in Minnesota are advising their employees on what to do if immigration agents show up — a possibility that had been remote until last week, when the federal government lifted its own restriction on enforcement actions around health care facilities.

Hospital workers at Children's Minnesota and Hennepin Healthcare received written guidance over the past week reminding them to preserve patients' federal privacy rights by not sharing information if government agents show up and to call security for help.

"The safety and privacy of our patients and families is a top priority," according to the Children's Minnesota guidance. "This includes maintaining confidentiality of patient information [and] not allowing any unauthorized personnel in patient care areas without a warrant or court order."

Despite social media rumors and reports, hospitals in Minnesota haven't verified any cases of immigration officials showing up on their campuses over the past week. Hospitals, schools and churches had been deemed "sensitive" areas that were largely off limits to immigration raids, but that changed on Jan. 20 under a directive from acting U.S. Department of Homeland Security Secretary Benjamine Huffman.

The more immediate concern for hospitals is that fears of immigration authority activity could discourage patients needing medical care from showing up to hospitals or clinics. An estimated 81,000 unauthorized immigrants live in Minnesota, according to recent estimates by the Migration Policy Institute, and about 45% of them have no health insurance — meaning they are less likely to make clinic appointments and more likely to go to emergency rooms with urgent medical needs.

"As Minnesota's largest public safety net hospital and healthcare system, we remain committed to serving anyone seeking care," read a statement from Hennepin Healthcare, which operates HCMC in Minneapolis. "Our healthcare professionals and those who support them ... are unwavering in this commitment."

The health system issued a memo to workers on Tuesday, urging them not to spread gossip of unverified immigration actions or legal advice.

"The response team is working on specific guidance that may be shared with patients and will distribute materials this week," the statement read. "In the meantime, do not share or distribute unofficial communications, fliers or other materials since it can spread misinformation and cause harm to our patients."

The change in federal policy is part of the new administration of President Donald Trump, who has pledged amid criticism to reduce crime and government spending in part through mass deportations of unauthorized immigrants.

Advocacy groups such as the National Immigration Law Center responded swiftly to the federal change with guidance for hospital workers, who could find themselves in dilemmas between cooperating with federal agents and upholding patients' federally protected privacy rights. The law center urged hospitals to clearly define public and private areas because immigration agents generally cannot enter private areas of hospitals without judicial warrants or permission from hospital personnel.

"Health care facilities should designate specific staff to act as authorized persons in such situations and train other staff to refer agents to the authorized persons and to avoid any action that could be interpreted as consent," the organization stated.

A social worker in the emergency department at Allina Health's Abbott Northwestern Hospital in Minneapolis forwarded many of these tips in a broadly distributed email to hospital staff, encouraging them to swiftly usher patients to private areas if immigration officers show up.

"Our duty is to our patients, regardless of where they are from or how they got here," the email read.

The worker wasn't authorized by Allina to provide the information, which wasn't vetted by its leadership. The health system said in a statement it is also sending reminders to its workers about how to handle encounters with law enforcement officials at clinics and hospitals.

Hospitals have reported a recent overall decline in patients after the spread of influenza and other infectious diseases in late December caused a surge of patients that peaked in early January.

Whether immigration concerns discouraged patients from showing up is unclear. Hospital workers sometimes ask patients about their immigration status if it helps them qualify for benefits, but they generally don't document that information in their electronic medical records.

If federal immigration actions surface around Minnesota hospitals, the state won't be interfering but also won't be helping, said Minnesota Attorney General Keith Ellison. The Democrat joined last week with colleagues from 21 other states and tried to block Trump's order to rescind citizenship to children born in the U.S. whose parents are unauthorized.

"We cannot stop the federal government from doing what it's their job to do. At the same time, you don't have to do their jobs for them, and we won't," Ellison said. "I'm not going to cooperate to help them do their job. ... I'm not spending one resource."