Death by a Thousand Cuts

Since its inception, ICE’s immigrant detention system has produced dozens of reports of preventable deaths and medical neglect. Despite attempts at reform and a class action suit, immigrants and asylum-seekers continue to receive substandard medical care, with deadly results

Kamyar Samimi spent the final hours of his life in a pool of bloody vomit, screaming for help, while detained in an Immigration and Customs Enforcement (ICE) facility.

Kamyar Samimi, who died in ICE detention in 2017 after being detained on a 2005 drug possession charge, had been a U.S. permanent resident since 1976. His family has since sued GeoGroup for wrongful death.(Courtesy of ACLU Colorado)

For days, he had been wracked with severe abdominal pain, nausea and vomiting, all symptoms of withdrawal from methadone. Before being picked up by ICE in November 2017, Samimi, a heroin addict in recovery, had taken the drug regularly for 20 years. As his health deteriorated over several days, nurses and ICE officials at the facility in Aurora, Colorado, ignored signs of the increasing severity of his condition.

“He’s dying,” said a nursing staff member on the morning of Dec. 2, 2017, hours before Samimi’s death. An internal agency review of his death published by Rocky Mountain PBS describes his final days in full, excruciating detail.

Although one nurse even noted the room smelled of “liver failure,” referring to the odor of his vomit, no one called 911 for several hours. At 11:06 a.m., a lieutenant facility officer finally came in and called for an ambulance, which took him to the hospital, where he was pronounced dead at 12:02 p.m.

When ICE officials arrested the 64-year-old Samimi on a decade-old nonviolent drug possession charge in 2017, Samimi was about to embark on his daily visit to a methadone clinic, reported Capital and Main. The day he was detained, Samimi was already in withdrawal. Less than three weeks later, he was dead.

“Methadone withdrawal cannot be ruled out as the cause of death, but deaths from methadone withdrawal are rare,” the local coroner’s report stated, ultimately deeming Samimi’s cause of death undetermined. An editorial from the academic journal Addiction suggests otherwise, asserting that any deaths from withdrawal from opiates, like methadone, are preventable with appropriate medical management.

“In each case the process of death appeared prolonged, with ample time to treat the person successfully,” the researchers from the University of New South Wales write, referring to a series of deaths in the American criminal justice system. “Why, then, did they occur? These were cases of neglect, or a lack of medical resources to support the individual.”

In ICE detention centers nationwide, immigrants live in facilities with grossly inadequate access to medical care that endanger their lives, as shown in several reports from third party government and nonprofit agencies. Caught in a patchwork, ill-equipped and poorly designed system, immigrants have suffered deaths that ICE deemed preventable as revealed in official agency death records. While waiting to have their immigration cases heard, which can take months to years, asylum-seekers and immigrants are often subject to abuse and mistreatment ranging from denial of and delay in proper medical care and prescription drug deprivation to negligent or falsified documentation of vital signs, diagnoses and more.

In California, ICE currently operates seven facilities; they are composed of three county jails that the federal agency contracts with and four privately owned facilities. All but one are owned GeoGroup and CoreCivic, the largest private prison companies in the country whose combined facilities hold over 60 percent of people in ICE detention. Closest to Los Angeles is Adelanto ICE Processing Center, a facility run by GeoGroup located in a remote desert town 90 miles from downtown. The federal Office of the Inspector General included Adelanto in a June 2019 report on four facilities with “immediate risks or egregious violations of detention standards.”

AUDIO: Former Detainees Recount Staff Abuse That Led to Injuries

Listen to the stories of two men, Jose Banos-Sarabio and Mina Soliman, who have both been detained in Adelanto ICE Processing Center. Their unique experiences of medical neglect and staff abuse are reflective of the system-wide issues with healthcare in ICE detention.

37-year-old Mina Soliman arrived at Los Angeles International Airport (LAX) in May 2018 seeking asylum from religious persecution in his native Egypt. Upon his arrival at LAX, he was immediately detained by ICE and transferred to Adelanto within days. Despite having no criminal record, he spent 18 months in detention until able to afford bond with the help of a Southern California nonprofit. While there, Soliman says he was abused and neglected after suffering a shoulder and knee injury in detention.

“It looks from the outside like they took care of me,” he said. “But in reality, I went through a lot of suffering.” Soliman said that his care was bungled several times in the process of recovering from the injuries.

In August, a coalition of civil rights groups brought a class-action suit against ICE and the Department of Homeland Security (DHS), on behalf of 15 plaintiffs alleging that immigrants are subjected to “horrific, inhumane, punitive and unlawful conditions” in detention. Nine are detained in California, primarily at Adelanto, with a host of serious conditions including cerebral palsy, schizophrenia and a parasitic brain infection that have gone untreated or poorly managed.

“The problem with this agency overall is that it's been allowed to police itself without any real checks from the Constitution,” said Liz Jordan, a lawyer representing some of the plaintiffs. Jordan works with the Colorado-based Civil Rights Education and Enforcement Center, one of the nonprofits that filed the case. She regularly represents asylum-seekers in detention. Speaking on an October panel at USC’s law school, Jordan said many of their testimonies match the conditions detailed in reports from government agencies and watchdog groups.

“All of our clients who’ve been in prison would rather be in prison,” she said. “They get more healthcare and more disability accommodations. We had one guy write a letter and be like, ‘Can you please just take me back to Pelican Bay and I will fight my ICE case from there?’”

Immigrants in ICE detention are a diverse group. As the enforcement arm of DHS, ICE arrests and detains people already living in the United States without documentation. Agents often wait for them outside their homes, schools and workplaces. With the cooperation of local authorities, they also wait inside prisons and jails, taking people into custody just as they are about to finish their sentences. Under the Trump administration, ICE has increased its efforts to conduct high-profile raids, like a July sweep targeting over 2,000 people and a sting operation where undercover agents created a fake university to lure 250 students into removal proceedings.

Those detained may have ignored orders to appear in immigration court, have an outstanding deportation order or a history of criminal charges. Any charge, however minor or non-violent makes an individual a target for arrest, detention and deportation. Those in ICE custody may also be permanent residents or green card holders, like Samimi.

People seeking asylum from persecution in their home countries form a second subgroup within the detention population. Many have arrived at the border without formally applying for refugee status, and are immediately transferred from Customs and Border Protection custody to ICE detention. At ICE’s discretion, asylum-seekers may be put in detention facilities while awaiting the results of their asylum cases or their release on bail.

Since the Obama administration, the immigrant detention population has steadily increased. Under Trump, ICE has begun to detain a higher proportion of people who have not committed any serious crime, according to Pacific Standard. Detention, once reserved only for those who posed a public safety threat or considered a flight risk, has expanded in size and scope.

Though the federal government considers ICE’s fragmented network of detention facilities a system of civil detention, conditions within many detention facilities are similar if not worse to prison and jails. Others are literally correctional centers and jails, operating on contracts to apportion some beds for those in ICE custody.

Not long after the agency opened its doors in 2003, reports of medical neglect and other inhumane conditions began to surface from the American Civil Liberties Union (ACLU) and the Washington Post. In 2008, the Post published the damning four-part series, "System of Neglect,” that documented medical neglect, forced sedation and denial of mental health services in ICE detention. An even earlier report from NPR investigated the death of Richard Rust, a Jamaican immigrant who died in detention.

"[N]ationally respected specialists on prison health care told NPR that if the detainees accounts are true — their stories are remarkably consistent — then the prison's efforts fell far short of the required standard of medical care,” NPR reported in late 2005, less than three years into the agency’s existence.

“It's not a secret that ICE detention is horrible and has really, really poor medical and mental health care,” class action suit lawyer Liz Jordan said, stating further that the agency has done almost nothing to address that since its inception. Despite reforms implemented in 2011 that established an Office of Detention Oversight (ODO) and move to a system designed for civil detention, immigrants are still housed in jails and private contract facilities and strikingly similar reports of abuse and neglect have continued to surface in the last eight years.

Immigrant Detention’s Long History of Medical Neglect

Since its inception in 2003 as the agency in charge of immigrant detention, ICE has run facilities that have produced a steady stream of reports of preventable deaths, detainee abuse and neglect. These are a few selected reports of the dozens available from across the country and several deaths that the agency itself found preventable.

Dec 2005

NPR investigates the death of Richard Rust and three other detainees

In the earliest report by a major media outlet of medical neglect, NPR investigates the death of Richard Rust, a Jamaican immigrant who died in detention at a facility in Oakdale, La. Despite attempts to get DHS and facility officials to respond to Rust’s deaths and three others, they refused to give a statement. ICE had only existed for less than three years.

May 2008

Disturbing reports of forced drugging and medical neglect released by the Washington Post

The Washington Post publishes an investigative series on medical neglect, inadequate mental health services, and forced sedation in ICE detention facilities nationwide. Independent review by medical experts found widespread medical neglect that may have contributed to 30 of the 82 deaths that occurred in ICE custody.

Feb 2009

Detained woman with AIDS dies due to ban on lab tests, nonprofit report finds

The Florida Immigrant Advocacy Center releases an independent report, “Dying for Decent Care: Bad Medicine in Immigration Custody" detailing violations of existing ICE medical guidelines and basic medical ethics. At a now closed detention facility in San Pedro, a ban on lab tests for any detainee held for under 30 days contributed to the death of Victoria Arellano.

Jan 2010

The New York Times reports on ICE's coverup of detainee deaths

A New York Times investigation conducted with the American Civil Liberties Union finds a paper trail that showed officials worked to “stymie outside inquiry” and sought to cover up or minimize the deaths of people in ICE custody. “If there’s a common thread, it’s the system. It really is a systemic problem,” one late detainee’s lawyer said.

Mar 2012

Man dies preventable death in Adelanto, facility passes inspection

Adelanto detainee Fernando Dominguez-Valdivia dies of pneumonia under circumstances that ICE’s internal death review summary later said “could have been prevented." The reports admits Dominguez-Valdivia “received an unacceptable level of medical care while detained.” Despite this, Adelanto passed internal inspection later that year.

Nov 2012

Orange County jail noted in nonprofit report of medical neglect and abuse

The Detention Watch Network issued a series of ten case-based reports, “Expose and Close,” including a report on Theo Lacy, a detention facility in Orange County with examples of substandard medical care and misuse of solitary confinement. Theo Lacy, a maximum security jail complex, stopped housing ICE detainees in August of this year.

Apr 2015

"A critical lapse in care:” Man dies of untreated cancer in ICE custody

Detainee Raul Ernesto Morales-Ramos dies following a delayed surgery to remove an abdominal mass. He had been held at Theo Lacy Facility from 2011 to 2014, and then Adelanto until his death. Two independent medical experts analyzed agency records of his case in 2016, concluding Morales-Ramos suffered from symptoms of cancer dating back to 2013.

May 2018

Inspector general finds Adelanto and three other facilities violate detention standards

The DHS Office of the Inspector General (OIG) conducts an unannounced inspection of Adelanto, finding several violations of ICE’s 2011 Performance-Based National Detention Standards, including nooses indicative of suicide attempts, overuse of segregation, and significant lack of medical and dental care.

June 2018

Human Rights Watch publishes report analyzing 15 deaths in detention, finds half preventable

The Human Rights Watch publishes a joint report analyzing 15 out of the 16 deaths in ICE custody from December 2015 to April 2017. Independent physicians with expertise in correctional health concluded substandard medical care played a role in contributing to 8 out of the 15 deaths.

Jan 2019

14 years later, detainees report the same issues of substandard medical care in CA

Advocacy group Human Rights First releases a report focusing specifically on immigration detention in California. Echoing reports of mistreatment and inhumane conditions that surfaced for over a decade, the conditions described in the report reinforce that little has changed since NPR’s investigation in 2005.

“I Was Afraid to Lose My Right Hand”

People currently in detention and those recently released confirm the current conditions of medical neglect and lack of resources within ICE facilities. Speaking from inside Adelanto, Anna, who requested her last name be withheld for fear of retribution from ICE agents, has experienced it firsthand. She says the inadequate medical care and poor conditions are reflected in the way facility health professionals treated the concussion and a light neck injury she sustained in May.

Anna wears her curly brown hair in braids, sporting horn-rimmed glasses with an out-of-date prescription that she says has worsened since the May incident. Her injuries occurred when another detainee jumped out of the top bunk while Anna was lounging in the bed below. Little of her face is visible due to the surgical mask she wears as required by a medical quarantine related to a chickenpox outbreak.

“They have falsified medical records in multiple ways,” she said. While under medical observation for 10 days in June, nurses filled out multiple forms indicating Anna refused attempts to measure her vital signs. She disputes this, saying that while incapacited due to the weakness, headaches and dizziness she experienced after the May incident, she was willing and able to cooperate with nurses.

Although her medical records from the Victor Valley Medical Center emergency room indicate she was diagnosed with both a concussion and cervical sprain, follow-up notes from Adelanto nurses have left out any mention of the concussion.

Anna says she also lost six pounds in the 10 days she was in the infirmary due to the poor food accommodations; when given her Jewish kosher breakast of oatmeal in the morning, the facility’s infirmary did not provide any hot water for her to eat.

“At a certain point, you stop filing grievances because nothing comes of it,” she said, referring to the process by which detainees can petition for better treatment. After filing a request to see a neurologist for residual effects of the concussion in June, she was finally able to see one at the end of October–four months later.

"They have falsified medical records in multiple ways.” -Anna, currently detained in Adelanto ICE Processing Center

Mina Soliman, who was released from Adelanto in November 2019, says he gave up filing grievances as well while injured in detention. In October of last year, he fell from the stairs inside his dorm, injuring his right knee and shoulder. He would spend 6 months of this year in a wheelchair recovering from both the fall and a subsequent infection in his left leg.

It took five months for Soliman to receive an MRI after his initial injury. In the interim, he spent 5 months living with severe pain and the increasing loss of range of motion in his right arm. At the time, he was afraid he would lose permanent use of his limb.

“Treatment could not be started until after the MRI. Before March, they only did an X-ray, even though I told them I felt like the bone was okay,” he said. Soliman was forced to see a nurse several times in order to get evaluated by an in-house physician. He finally received an MRI after visiting the doctor four or five times.

“Every time I went to see [the physician] he would tell me, ‘I’m not seeing anything wrong in your knee, and you don’t have any justification to go through all this and the MRI. It’ll cost us money,’” Soliman says. “I told them, ‘I have no idea about the money. I’m just asking for medical treatment.”

“I was afraid–this is my right hand, you understand, Kelly? I was afraid to lose my right hand.” -Mina Soliman, former detainee

When he did receive the report, the physician finally told him there was a “serious issue.” Only then did he begin a course of physical therapy, which ICE health professionals administered so infrequently that his knee and shoulder saw next to no improvement. They found every excuse, he says, to not give him the treatment he needed.

Already aware of the low likelihood of getting adequate physical therapy, he decided against a shoulder surgery an orthopedic surgeon recommended. “I was afraid because another detainee did surgery in his eyes, and he didn’t get the correct medical treatment after the surgery,” he says. His shoulder injury severely limited the range of motion in his right arm, and he became increasingly depressed about the possibility of never recovering.

“I was afraid–this is my right hand, you understand, Kelly? I was afraid to lose my right hand.”

In January, Soliman came down with an unrelated infection in his left leg. The limb became red and swollen to the point he could no longer move. On the night he was admitted to the ER, the guards began to verbally abuse Soliman, asking him “Who do you think you are?” and telling him to go back to his country. It was 2 a.m. and he was exhausted, scared and anxious as he waited to go to the hospital.

Soliman asked them repeatedly to stop speaking so harshly to him. When he got up from the chair he was sitting in, using the cane he had been using to steady himself since the accident, one of the guards attacked him.

“He took my left hand and he squeezed my hand, twisted my wrist, and pushed me to the floor,” Soliman says. He hit the floor on the right side of his back, which he had already injured. When he was finally transported to the emergency room, the facility guards pretended as though the incident didn’t happen.

Back in ICE’s in-house medical suite, he was given a course of antibiotics that did little to quell the infection. For three months, he used a wheelchair, unable to walk due to his original injuries as well as the swelling in his knee. His Adelanto physician put him on three different antibiotics, none of which worked to combat the infection.

Soliman finally received an antibiotic that worked after he convinced the doctor to take a sample of the fluid leaking from his wound to identify the correct pathogen.

“If they have the ability to take a sample and find what is the perfect antibiotic from the first time, why did they not do that?” Soliman asks. “Why did I have to suffer for four months with the wrong antibiotics?”

Today, Soliman is a free man, released on bond and awaiting a hearing on his asylum case in the greater Los Angeles area. He hopes that by sharing his story, the injustices he endured in detention won’t keep happening to others.

America's "Truly Civil Detention System"

America’s system of immigrant detention, and allegations of inhumane treatment and neglect within, dates back to the Reagan administration. Faced with a wave of migrants from Haiti following political upheaval, Attorney General William French Smith used a component of the Immigration and Nationality Act of 1952 that stipulated that immigrants without visas could be detained for further investigation to justify the detention those arriving on the shores of Florida.

From the beginning, ICE has relied on private prisons and agreements with state and county jails across the country to house detainees. This piecemeal arrangement has contributed to a system of widespread neglect with little accountability despite internal oversight, third-party inspection and numerous accounts of preventable deaths and abject conditions that fail to meet the constitutional standards for the basic human needs of those in custody.

Over the last four decades, the detention population of fewer than 3,000 immigrants a day in the late 1970s has ballooned to a fluctuating population that reached an all-time high of 55,185 in March according to Pacific Standard. Since the Clinton administration, the population has increased sixfold, profoundly changed by a pair of laws passed in 1996. Together, those two laws have expanded the number of crimes that made a person subject to deportation and given immigration officials wider discretion to make removal decisions without a judge.

ICE as a federal agency, however, only been in existence for the last 16 years. In 2002, George W. Bush signed the Homeland Security Act, creating the Department of Homeland Security (DHS) and absorbing the duties of the Immigration and Naturalization Service (INS) and U.S. Customs Service. By March of 2003, ICE, along with Customs and Border Protection, the agency in charge of the camps at the border, had opened its doors.

Bush signing the Homeland Security Appropriation Act of 2004. In 2002, President Bush initiated the most ambitious restructuring plan for border protection and immigration in American history. (White House photo by Tina Hager)

In its first few years, reports emerged from the ACLU, the New York Times and the Washington Post recounting abuse by guards, denial of basic medical care and conditions that violated basic human rights. A joint ACLU and Times investigation found officials worked to “stymie outside inquiry” and sought to cover up deaths in ICE custody.

“ICE detention is particularly difficult because in this context of inadequate healthcare for everybody who is locked up,” said Dr. Homer Venters, speaking on the October panel on immigrant health at USC. A physician, epidemiologist, and former chief medical officer of the New York City jail system, Venters is an expert in correctional health.

“We have this very complicated spread out system of over 200 places where people are held,” he said. Venters doesn’t blame the individual nurses, doctors and other healthcare professionals working within ICE, saying that the poor quality of care is largely due to the systemically disproportionate authority ICE officials and facility employees wield over medical decisions for detainees.

By 2009, spurred by growing criticism, Obama administration officials enacted a series of reforms with an eye to increased centralization, direct federal oversight and improved safety and accountability. Intended to transform it to a “truly civil detention system,” the reforms implemented in 2011 created a new agency office, the Office of Detention Oversight (ODO), that would review deaths in custody, implemented a new facility inspection scheme, and introduced a new set of detention standards, the 2011 Performance-Based National Detention Standards.

An ICE Health Service Corps member with a detainee at Batavia Federal Detention Facility in upstate New York in 2015. Despite the existence of the corps, reports of substandard care continue to come out of detention facilities nationwide. (Josh Denmark/DHS via Flickr)

Modeled on guidelines from the American Correctional Association, the 2011 standards still fall short of medical care requirements in prison and jail settings for a population that is not being held on criminal charges. These standards, an update to standards first proposed by the INS in 2000, have not actually helped improve conditions in detention across the board. A 2018 report from the Office of the Inspector General also found ICE’s inspection scheme and monitoring did not lead to increased compliance with the 2011 standards or systemic improvement in detention conditions.

Since the agency implemented the reforms, little has changed in terms of the narratives of medical neglect, lack of resources and conditions of cruelty emerging from those in detention. The circumstances around deaths are no better–Kamyar Samimi’s death occurred in 2017. A review of his death by the ODO released a year and a half later paints in explicit detail the myriad of ways the Aurora facility failed to treat his opioid withdrawal or alert a qualified medical professional.

“We don't know all the ways in which [ICE] healthcare fails. We know about outcomes,” said Venter. “Most of the people who are detained end up being deported. So unlike jail and prison where people have ties to family, to coming back home, many of the worst health outcomes actually happen after, where people die.”

Since the establishment of the ODO, ICE has done extensive reviews of all deaths occurring in detention, including Samimi’s. It is required by a 2018 bill to make all reports of a death in custody public within 90 days. During the Trump administration, 30 people have died while in ICE detention. What this number does not convey, however, is the myriad people who have died as a result of disruptions in care or medical neglect while in detention.

“We don't know all the ways in which [ICE] healthcare fails. We know about outcomes."
-Dr. Homer Venters

“Imagine you're on dialysis and you're picked up, you go into ICE detention,” Venter told the audience at USC’s law school. “You might even get dialysis while you're there. Then you're flown back home and given a piece of paper saying, ‘So this is where you could go in El Salvador for dialysis. 200 bucks a shot.’ That's a death sentence.”

For 33-year-old Ajay Kumar, an Indian asylum-seeker, death was a very real possibility as he was force-fed in a Texas detention center. After being in detention for over a year, Kumar went on hunger strike in July. In August, ICE sought and received a court order to begin force-feeding him and two other Indian men. Force-feeding itself is an ICE practice that the United Nations has warned is a possible violation of the UN convention against torture.

On August 16, the ICE physician began the precarious procedure of force-feeding Kumar, a process that can result in malnourished patients experiencing severe, sometimes fatal electrolytic shock. In the process, physicians typically check vital signs every six hours, said Dr. Parveen Parmar, an associate professor at USC Keck School of Medicine and emergency medicine physician.

Kumar’s signs were checked every 12 hours, if that, in the critical refeeeding period.

Parmar would go on to write it was “the worst medical care I have seen in my 10 years of practice” in a medical affidavit in support of his asylum case. “This lack of appropriate attention to critically low blood pressure and astonishingly infrequent MD evaluations of a very ill patient, on whom treatments are being forced without their consent, would never be tolerated in any hospital,” stated Parmar.

“I was genuinely terrified for [Kumar] because the vital signs I was seeing were peri-code vital signs–blood pressures in the 50s. Normal blood pressure is 120 systolic over 80, right?” Kumar told the audience at the ICE immigrant health panel. “Really severe signs of illness and shock were being ignored with critical vital signs.”

“the worst medical care I have seen in my 10 years of practice”
-Parveen Parmar's commentary on a detainee on hunger strike

Parmar, a human rights advocate who regularly writes affidavits of support for asylum-seekers, also points out that the agency’s lack of transparency in reviewing deaths is emblematic of its overall lack of accountability and unwillingness to reform itself. “ICE is not doing [ODO detainee death] reviews in a timely fashion, or releasing them in a timely fashion,” she said.

“If you're looking at a hospital system, any kind of healthcare system and your goal is to fix issues that led to a death, you want a timely review and you want there to be some external accountability, so that there's actually some changes made in response to the deficiencies that were found.”

When it comes to ICE, however, external accountability is nonexistent. Unlike in regular health systems, which are governed by accreditation agencies like the Joint Commission, ICE detention has no such external auditing body capable of holding it accountable.

“There's actually quite a bit of nuance and sophistication to most mass incarceration systems,” said Venter at the start of the ICE immigrant health panel. “It's just that they have been designed purposefully with a lack of data and a lack of information about the ways in which they harm people who go into them.”

Nakamoto Group, the independent contractor ICE hires to inspect its facilities, has been accused of glaring oversights of conditions in detention, with the company’s reports often in direct contradiction to the alarming reports from the DHS inspector general, state auditors and advocacy groups. Even the Performance-Based National Detention Standards are internal agency standards, unenforceable by law.

Immigrant Detention’s Uncertain Future

According to the legal and medical experts on the USC law school panel, the ideal response to this legacy of medical neglect would be to abolish ICE’s immigrant detention system altogether. “ICE is categorically different [from the penal system] because this is civil detention, and we don't need to do it,” said Venter.

In the interim, however, the best attempts to reform the healthcare standards within detention come from the work of lawyers like Jordan and Jared Davidson of the Southern Poverty Law Center, both of whom are working on the ongoing class action suit against ICE.

“I’m a bit of a pragmatist. Hopefully, we will abolish ICE, but in the meantime people are committing suicide in Ridgewood, La., and deteriorating in 160 other facilities across the country,” said Davidson. “Litigation and other advocacy to make conditions better and enhance oversight is paramount.”

Parmar cautioned against assigning blame to individual healthcare professionals, particularly those who have dual loyalties when employed by private companies like GeoGroup.

“No health staffer on their own is the solution, right?” said Venter, who has conducted surveys of health professionals working in jails. “[Those surveyed] talked very freely about [the pressure to alter patient’s medical notes]. It’s not that they don't know what's going on, it's that they face immediate retaliation.”

Growing opposition to ICE detention in California has ended contracts with existing county jails and shuttered facilities that house detainees. Today, seven facilities throughout the state work with ICE, with three jails having ended their contracts in the last year. In early October, governor Gavin Newsom signed AB32, a bill that would phase out all private prison facilities by 2028. The bill also prevents state and local authorities from signing contracts with private prisons beginning in January of this year.

For ICE, this means the likely closure of Adelanto and its three other privately-owned facilities. In the meantime, however, the agency has attempted to circumvent the ban, posting a request for new private facility contracts in California on the Federal Business Opportunities website. The requests closely matched the capacity of existing detention centers, reported the Los Angeles Times.

Those following the increasing attempt at the state and local level have cheered these attempts to shut ICE out of California. What this spells out for the standard of medical care within detention facilities, however, is unclear.

“The whack-a-mole problem of ICE’s patchwork national system means that people are now in custody in New Mexico,” Jordan said. I think it's going to be up to the advocacy community to say, ‘No, right, like this is not okay in other states either.”

Jordan believes, however, that the symbolic gesture alone is important in letting companies like GeoGroup and CoreCivic know they are not welcome in communities. Until immigrant detention undergoes a drastic overhaul or is abolished completely, people will continue to suffer and even die without consequence for the agency that has openly admitted such deaths are preventable.

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Acknowledgements and thanks to: Taylor Saraffian, Harrison Liddiard, Keith Plocek and Peggy Bustamante for code debugging; Freedom for Immigrants, Inland Coalition for Immigrant Justice, Margaret Brown-Vega and more for assistance in background and sourcing; Juan Delatorre for translation.