Health Law and Immigration Detainees

Immigration detainees represent a rapidly expanding population for whom medical care is not legally guaranteed. These detainees, numbering over 30,000 at any given time and over 300,000 annually, are held across the U.S. in a heterogeneous mixture of local jails, state and federal prisons and private contract facilities. Unlike criminal prisoners, immigrants detained by Immigration and Customs Enforcement (ICE) lack a guarantee to medical care. In addition, although ICE promulgates standards concerning all aspects of detention, including medical care, these guidelines generally lack enforcement or administrative weight. Several attempts have been made to codify current ICE medical care guidelines into legislation, without success. We have reviewed current ICE medical guidelines, proposed legislation and reporting by advocacy groups and others. Proposed legislation has generally involved a simple codification of existing ICE medical standards with minimal alteration. Key aspects of establishing medical care that are absent from proposed legislation include specific monitoring and reporting of detainee population health as well as mandating an outside standard for accreditation of detention centers in a manner similar to jails and prisons. We propose that the most recently introduced detainee medical bill (HR-5950) be re-introduced this Congressional session with inclusion of these specific items. In addition, we propose that ICE issue current medical standards in the form of regulations so as to imbue them with greater enforceability. Finally, we urge the departments of Homeland Security (ICE) and the Department of Justice (US Marshalls, Federal Bureau of Prisons) to adopt a common set of medical standards.