The ICE Health Service Corps (IHSC) is the only entity in ICE with the responsibility of providing direct care. IHSC is made up of a multi-sector, multidisciplinary workforce of over 1100 employees that include U.S. Public Health Service (PHS) Commissioned Corps officers, federal civil servants and contract health professionals. IHSC is committed to providing health care services to reduce global disease and support the safe apprehension, enforcement and removal of detained individuals involved in immigration proceedings. The Assistant Director (AD) for IHSC is responsible for all administrative and operational elements crucial to sustaining the IHSC health care system, and consequently all activities related to the health care of detainees in ICE custody.
IHSC provides 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 also provides case management and oversight for an additional 15,000 detainees housed at approximately 119 non-IHSC staffed detention facilities across the country. In many instances, the care that detainees receive while in ICE custody is the first professional medical care they have received, and it is common for detainee health screenings to identify chronic and serious health conditions that were previously undiagnosed. IHSC oversees the financial authorization and payment for off-site specialty and emergency care services for detainees in ICE custody.
IHSC-staffed facilities utilize applicable health care standards drawn from the American Correctional Association (ACA), the National Commission on Correctional Health Care (NCCHC), ICE National Performance-Based Detention Standards, and ICE Family Residential Standards to ensure that quality care is provided to detainees. These standards support IHSC’s internal quality improvement program.
During Alien Migrant Interdiction Operations (AMIO), IHSC works with the U.S. Coast Guard (USCG) Sector Key West and provides health care to migrants on board USCG vessels to help stabilize and return the migrants to their country of origin. IHSC also provides medical support during flight and sea operations through the IHSC Special Medical Operations Unit. This Unit consists of specially trained PHS officers who, in addition to meeting the medical needs of detainees, serve as liaisons between law enforcement officials and other key stakeholders.
Manuel felt sudden intense chest pain and had difficulty breathing.
He knew something was terribly wrong and called out for his deportation officer. His current place of residence: a U.S. Immigration and Customs Enforcement (ICE) detention facility in Jena, Louisiana.
The deportation officer immediately announced a facility medical emergency and notified 911 while another staff member rushed over and began life-saving chest compressions on Manuel. The rest of the medical response team arrived within two minutes and observed Manuel was not breathing and pulseless. They assisted with providing emergency care, revived his vital signs and stabilized him until the ambulance arrived and transported him to the nearest hospital for additional care.
A typical day for the ICE Health Service Corps (IHSC).
Vision: To be the best health care delivery system in detention and correctional health care.
Mission: Provide the safe delivery of high-quality care to those in ICE custody.
- Integrity: We consistently conduct business and deliver goods and services openly, honestly, and to the best of our ability.
- Commitment: We are committed to providing quality, cost-effective health care in collaboration and partnership with both federal and non-federal partners.
- Accountability: We are responsible for our personal and organizational decisions, actions, and results. We are good stewards of government funds and resources.
- Service: We strive to satisfy and meet the needs of the organization and stakeholders in support of immigration law enforcement.
- Excellence: We provide services and mission support utilizing highly qualified health care professionals in order to work towards achieving optimal outcomes.
The ICE Health Service Corps administers direct care to 14,000 detained illegal aliens in 21 facilities across 10 states. A medical delivery care person staffs each facility 24 hours a day, seven days a week for direct patient access.
The corps consists of physicians, nurse practitioners, registered nurses, psychiatrists, psychologists, social workers, pharmacists, dentists and administrators.
Assistant Director, Dr. Stewart D. Smith, strongly believes in the mission and capabilities of the integrated corps team.
“The ICE Health Service Corps staff comprises the highest caliber of health professionals who have chosen detention health care as a noble and rewarding career,” he said. “Our team is second to none.”
Dr. Luzviminda K. Peredo-Berger, chief medical officer, understands the challenges of working with a detained population of individuals.
“Our population has a very rapid turnover; we have a limited time span in which to see patients,” she said, “we don’t have long to make a determination.
“Our evaluation of each patient is an intake process. We have a pre-screening then a formal screening to check for any health issues that are urgent, emergent, chronic or acute. The intake is the patient’s first and most important interaction with our medical team.
Every ICE detainee receives a full health assessment with 14 days of entry into the system. Detainees identified as high-risk during the intake process are triaged to a higher level of care immediately. If at any time a patient verbalizes an issue such as, “I feel very bad” or “I don’t have the medicine I need,” a nurse or mid-level practitioner has the authority to interact with a higher level medical provider to determine when the patient can be seen by a physician within 24 hours.
The corps recognizes the need for patient privacy, honors patient requests for same gender, or preferred gender, providers, and utilizes a telephonic language line for assistance with translation and dialect interpretation when needed.
ICE embraces nationally recognized performance standards for detention and healthcare delivery and the ICE Health Service Corps conducts a significant amount of training to ensure excellent detainee care. The implemented standards and training provide medical personnel with credentials that endure more scrutiny than any other integrated health delivery program in the nation. ICE enforces its standards with regular reviews, on-site assessments and corrective action plans, if needed.
The detained population of illegal aliens present unique health care challenges. For example, some detainees have recently come into the United States under dangerous conditions and may be suffering from dehydration, injuries, misdiagnoses or previously existing medical conditions.
“We sometimes find,” said Dr. Peredo-Berger, “that detainees have never been seen by any medical personnel at all.”
The three family residential centers ICE maintains, in Dilley and Karnes, Texas, and Berks, Pennsylvania, each have their own standardized care delivery system to accommodate a unique population that includes women and children. The three centers provide ongoing training to detainees that include: parenting classes, school for children with certified teachers, language classes, social skill training, social networking, nutrition classes, internet training, library training and how to use a law library.
Dr. Peredo-Berger emphasizes that ICE detention centers are not prisons or jails; they are detention facilities. She said,
She also makes the point that seeing a doctor in private practice within 24 hours is an impossibility, but with the corps sick call system, detainees are able to do just that. “We have a full complement of integrated health professionals collaborating to make a short-term health care system for detainees. I’ve received thank you notes from patients who have said the health care they received from ICE has far exceeded anything they expected.”
The corps provides top level health care within the confines of the detention environment because that is what is required.
“They are dedicated to getting the best patient outcomes possible.”
ICE Health Service Corps Accreditations and Credentials
- American Correction Association (ACA)
- National Commission on Correctional Health Care (NCCHC)
- National Practitioner Data Bank
- ICE Family Residential Standards
- ICE Performance Based National Detention Standards