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To the U.S. Department of Homeland Security
- Ensure the adequacy of care for detainees by increasing the number and quality of inspections by the DHS Office of Inspector General. This will require strengthening the internal monitoring capacity of the Detention Standards Compliance Unit that should have the capacity to conduct multiple on-site inspections, including unannounced ones, of each facility housing detainees. Monitors should interview detainees. Monitors should possess the expertise to ensure that each facility complies with national and international correctional health care standards by providing medical care equivalent to that afforded in the community.
- Ensure the adequacy of care for detainees by revising the Medical Care Detention Standard, including the provisions related to HIV/AIDS, to conform to standards established by the National Commission on Correctional Health Care, the American Public Health Association Standards for Health Care in a Correctional Setting, or other nationally recognized standards that require medical care equivalent to that afforded in the community.
- Protect vulnerable populations from abuse and harassment by revising the Detention Standards to include a non-discrimination policy with education, training and enforcement provisions for the protection of lesbian, gay, bisexual, and transgender detainees and detainees with HIV/AIDS.
- Ensure transparency and accountability to the public by converting the Medical Care and other Detention Standards to federal administrative regulations. The promulgation of regulations would provide the public with an opportunity for comment and dialogue with the Department, increasing the transparency of immigration detention procedures. The issuance of regulations would provide legal recourse to detainees in the case of violation.
- Promote alternatives to detention for immigrants with HIV/AIDS and other chronic medical conditions. Ensure implementation of existing policies permitting prosecutorial discretion in such cases.
Ensure the adequacy of care for detainees by gathering information from all detention facilities holding immigrants about the number of detainees with HIV/AIDS and the treatment and services provided to them. This information should inform the development of evidence-based policies and programs designed to address the needs of this vulnerable population.
Ensure the adequacy of care for detainees by revising the HIV/AIDS provisions of the Medical Care Detention Standard to ensure access to voluntary testing and counseling. These provisions should ensure informed consent, confidentiality and counseling and should conform to national and international recommended standards for HIV/AIDS testing in a correctional setting.
- Incorporate and require compliance with Medical Care Detention Standards (as revised above) as an express condition of contracts with private, local or county facilities. Provide training to each facility designed to ensure compliance with the standards.
- Improve the current system for tracking complaints from detainees. Ensure that complaints relating to medical care can be monitored and serious or systematic violations of the medical care standards can be identified and redressed. Ensure that detainees who complain are protected from retaliation. Ensure that all immigrants detained by ICE receive notification of complaint procedures in their native languages.
- Ensure that all detainees receive medical services free of charge.
To the U.S. Government Accountability Office
- Increase executive and legislative branch oversight of conditions of detention for immigrants by ensuring that ICE has taken appropriate action in response to the recommendations in its recent report.
To the U.S. Congress
- Ensure that all immigrants detained in federal custody are subject to comparable standards of medical care. These standards should comply with national and international correctional health care standards by requiring medical care equivalent to that afforded in the community.
- Establish a monitoring body independent of the Department of Homeland Security with the responsibility and the expertise to ensure that each facility housing immigration detainees complies with national and international correctional health care standards by providing medical care equivalent to that afforded in the community.
December 2007
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