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“Fatal Neglect” Report Faults ICE Health Care for Deaths of Detained Immigrants

The American Civil Liberties Union (ACLU), Detention Watch Network (DWN) and National Immigrant Justice Center (NIJC) issued a joint report, “Fatal Neglect: How ICE Ignores Deaths in Detention,” that describes case studies of deficient medical care resulting in the deaths of detained immigrants. The report, released in February 2016, accuses Immigration and Customs Enforcement (ICE) of failing to follow accepted medical practices and even its own revised standards for providing health care to detainees – many of whom are in civil detention awaiting asylum hearings.

According to the report, 56 detainee deaths have occurred in ICE custody during the Obama administration, including six suicides. Federal officials formulated new ICE standards for immigration detention facilities in 2009, then again in 2011. Following the implementation of the 2009 standards, ICE’s Office of Detention Oversight (ODO) began producing detainee death reviews, which were obtained by the ACLU through Freedom of Information Act (FOIA) requests.

The more recent 2011 standards were not in effect at ICE facilities during the time period covered by the joint report. However, even though they are considered “the most thorough standards,” they still “fall short in significant respects compared to the National Commission on Correctional Health Care (NCCHC) standards for medical care in prison and jail settings.”

The report states that the “ACLU’s updated FOIA request sought the ODO reviews of 24 deaths that occurred in ICE custody from January 2010 through May 2012,” after the 2009 revised standards went into effect. The report focuses on eight detainees who died in ICE custody, and describes in chilling detail the apparent inability – or unwillingness – of ICE to address serious deficiencies in the agency’s medical treatment protocols.

Even by January 2014, “139 facilities holding 44 percent of detained immigrants still operated under other, outdated standards that were promulgated as early as 2008, or even in 2000, prior to the creation of ICE.” Some of those facilities were not even contractually obligated to follow the new medical treatment standards.

Congress has shown an interest in compelling ICE to improve its medical care, including in legislation specifying the agency “cannot expend funds to immigration detention facilities that fail two consecutive ... inspections.” However, even the new inspections mandated by Congress have many flaws and may not be rigorous enough to markedly improve medical care for detained immigrants.

Deficient inspections clearly contributed to the eight deaths highlighted in the report, which notes that negative inspection findings were “essentially swept ... under the rug.” A lack of accountability and transparency was widely seen as contributing to health care inadequacies at ICE facilities, as has been the case with other federal agencies such as the federal Bureau of Prisons. The ACLU, DWN and NIJC have complained that ICE continues to drag its feet in complying with their latest FOIA requests regarding detainee medical-related issues.

The three organizations made several recommendations to improve ICE’s health care system. First, reduce the number of detainees to maximize resources available for medical care. ICE currently operates under a “bed mandate” that requires the agency to hold at least 34,000 detainees at any given time. [See: PLN, Jan. 2016, p.46]. Second, improve the delivery of medical care by requiring all detention facilities to adopt ICE’s 2011 standards, by revising them to incorporate NCCHC standards for medical care in prisons and jails, and by “end[ing] the use of private for-profit detention facilities and for-profit medical care sub-contractors.” Third, improve the quality of ICE detention facility inspections, to ensure that if problems are uncovered they are promptly corrected, by dismantling the agency’s “culture of secrecy.”

Lastly, increase the transparency of inspections, in-custody deaths and medical incidents at immigration detention facilities by making ODO death reviews, inspection reports and related documents publicly available, and by creating an “independent medical advisory committee to investigate deaths that occur in detention.”

Source: “Fatal Neglect: How ICE Ignores Deaths in Detention,” by the ACLU, Detention Watch Network and National Immigrant Justice Center (Feb. 2016); available at:, or

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