The U.S. Immigration and Customs Enforcement (ICE), Enforcement and Removal Operations (ERO) is responsible for ensuring safe and humane conditions of confinement for detained aliens in ICE custody, including the provision of reliable, consistent and appropriate health services.
ICE Health Service Corps (IHSC) provides and coordinates the primary health care services for detainees in ICE custody. IHSC is made up of a multi-sector, multidisciplinary workforce of over 1100 employees that consists of U.S. Public Health Service Commissioned Corps officers, federal civil servants and contract health professionals. IHSC administers direct care to approximately 13,500 detainees housed at 21 designated facilities throughout the Nation, to include medical, dental and mental health care, and public health services. IHSC provides medical case management and oversight for an additional 15,000 detainees housed at approximately 119 non-IHSC staffed detention facilities across the country. In addition, IHSC oversees the financial authorization and payment for off-site specialty and emergency care services for detainees in ICE custody.
Key Facts and Statistics from FY 2015
The following number and types of health care services were provided in FY 2015:
- Intake Screenings: 199,107
- Physical Exams: 87,078
- Sick Calls: 126,486
- Urgent Care Visits: 21,245
- Emergency Room/Off-Site Referrals: 19,483
- Dental Visits: 24,233
- Mental Health Interventions: 90,276
- Prescriptions Filled: 234,001
In a typical day IHSC provides approximately 545 health screenings, 239 physical exams and 347 sick calls.
Detainee Health Process
Each ICE detainee undergoes a health screening within the first 12 hours of admission to an ICE detention facility. This screening includes an evaluation of the detainee’s medical, dental and mental health status. A more detailed health history and physical examination is also provided to ICE detainees within 14 days of admission to a facility. Detainees who present with acute or chronic health care needs are referred to a primary care provider for further evaluation and medical treatment. Pregnant detainees are referred to community obstetrics specialists to ensure that appropriate prenatal care is delivered. Those identified as having an infectious disease are placed in the appropriate health care setting, and they are provided the most suitable treatment plan for their condition. Detainees with diseases such as HIV/AIDS are treated in accordance with nationally recognized standards and guidelines.
Each facility housing ICE detainees has a written plan for the delivery of 24-hour emergency health care that includes provisions of care when immediate outside medical attention is required. All facilities have current arrangements with nearby medical facilities, or health care providers, to administer health care not directly provided within the facility. Each detainee receives health care counseling and instruction, and is provided discharge planning to assure continuity of care.
IHSC seeks to minimize threats to public health domestically and globally by controlling tuberculosis and other infectious diseases of public health significance. IHSC staff screen detainees for active tuberculosis disease at intake, which allows prompt evaluation, management, and implementation of infection prevention and control measures. IHSC medical staff and its Public Health, Safety, and Preparedness Unit staff monitor detainees identified with tuberculosis while in custody to ensure appropriate evaluation, management and coordination with public health authorities, and to facilitate continuity of care. The facilitation of continuity of care is performed whether a detainee is released from custody into the United States, or if the detainee is returned to his or her country of origin. IHSC coordinates with domestic and foreign national public health authorities to establish a referral that allows released detainees to continue anti-tuberculosis therapy without interruption and until completion of the treatment. IHSC also has a program to identify HIV treatment resources for detainees living with HIV to continue their care following release from ICE custody.
Quality Assurance and Oversight
IHSC-staffed facilities utilize applicable health care standards drawn from the American Correctional Association (ACA), the National Commission on Correctional Health Care (NCCHC), and the ICE National Performance-Based Detention Standards to ensure that quality care is provided to detainees in the custody of ICE.