Medical Neglect in ICE Detention: Rights and Reporting

Medical Emergency?

If someone is experiencing a medical emergency in detention:

Demand immediate medical attention - Repeat requests to multiple staff
Have family call the facility - External pressure can help
Contact attorney - They can file emergency motions
Call DHS OIG: 1-800-323-8603

Medical Rights in ICE Detention

What Detainees Are Entitled To

Under ICE detention standards (PBNDS 2011), detained individuals have the right to:

[ ] Initial health screening within 12 hours of arrival
[ ] Comprehensive health assessment within 14 days
[ ] Emergency medical care at all times
[ ] Ongoing treatment for chronic conditions
[ ] Mental health services
[ ] Dental care for emergencies and essential needs
[ ] Prescription medications continued from prior to detention
[ ] Sick call requests responded to within 24 hours
[ ] Referral to specialists when needed
[ ] Medical information in a language they understand

What ICE Cannot Do

Detention facilities are prohibited from:

Denying emergency medical care
Ignoring serious medical conditions
Withholding prescribed medications
Punishing detainees for requesting care
Using medical care as reward or punishment
Ignoring mental health emergencies

Recognizing Medical Neglect

Types of Medical Neglect

Type	Examples
Denial of care	Ignoring sick call requests, refusing to see doctor
Delayed care	Days or weeks to see medical staff for urgent issues
Inadequate care	Dismissing symptoms, superficial examinations
Medication issues	Wrong dosage, wrong medication, withheld medications
Chronic condition neglect	Uncontrolled diabetes, untreated HIV, no dialysis
Mental health neglect	No psychiatric care, medication discontinuation
Dental neglect	Untreated infections, extractions instead of treatment
Pregnancy neglect	No prenatal care, inadequate monitoring

Warning Signs

Physical symptoms that need immediate attention:

Chest pain or difficulty breathing
Severe abdominal pain
High fever (over 103°F)
Signs of stroke (face drooping, arm weakness, speech difficulty)
Severe bleeding
Loss of consciousness
Diabetic emergency (very high or low blood sugar)
Severe allergic reaction
Seizures

Signs care is being denied or delayed:

Multiple sick call requests with no response
Being told to "wait" repeatedly
Symptoms worsening over time
Running out of prescribed medications
Being told condition is "not serious" without examination
Punishment for requesting medical care

What to Do If Care Is Denied

Immediate Steps

Step 1: Document Everything

Date and time of each request
Name of staff member you spoke to
What you requested
What response you received
How symptoms are changing

Step 2: Make Repeated Requests

Submit written sick call requests
Keep copies of all requests
Note when you submitted and to whom
Escalate to supervisor if no response

Step 3: Request to See Medical Staff

Ask specifically to see a doctor or nurse
State your symptoms clearly
Say "I believe this is an emergency" if applicable
Request documentation of any visit

Step 4: Contact Outside Support

Tell family members about the situation
Have them call the facility demanding care
Contact your attorney
Call advocacy hotlines

Documentation Template

┌─────────────────────────────────────────────┐
│         MEDICAL REQUEST LOG                 │
├─────────────────────────────────────────────┤
│                                             │
│  Date: _______________                      │
│  Time: _______________                      │
│                                             │
│  Request Made To:                           │
│  Name: ________________________________     │
│  Title: ________________________________    │
│                                             │
│  Symptoms/Complaint:                        │
│  ________________________________________   │
│  ________________________________________   │
│  ________________________________________   │
│                                             │
│  Response Received:                         │
│  ________________________________________   │
│  ________________________________________   │
│                                             │
│  Action Taken:                              │
│  □ Seen by medical staff                    │
│  □ Given medication                         │
│  □ Referred to doctor                       │
│  □ Told to wait                             │
│  □ Ignored/No response                      │
│                                             │
│  Witness: ______________________________    │
│                                             │
└─────────────────────────────────────────────┘

How Family Can Help

If Your Loved One Reports Medical Issues

Immediate Actions:

Document what they tell you
- Specific symptoms
- How long they've had them
- What requests they've made
- What responses they received
Call the facility
- Ask to speak with medical department
- State your concern clearly
- Ask what care is being provided
- Document who you spoke with
Contact their attorney
- Attorneys can file emergency motions
- They can contact facility directly
- They may request medical records
Report to oversight agencies
- DHS OIG: 1-800-323-8603
- CRCL: dhs.gov/file-civil-rights-complaint

What to Say When Calling Facility

"I am calling about [Name], A-Number [A-Number].
I am their [relationship].

They have reported [symptoms] for [duration].
They have requested medical care on [dates]
and have not received adequate treatment.

I am requesting that they receive immediate
medical attention. Please document this call.

Who am I speaking with? [Get name and title]
What will be done to address this? [Document response]

I will be following up and have reported this
to DHS oversight agencies."

Reporting Medical Neglect

Where to Report

1. Facility Grievance System

File formal grievance immediately
Request copy of grievance
Note grievance number
Follow up on response

2. DHS Office of Inspector General

Phone: 1-800-323-8603
Online: oig.dhs.gov/hotline
Report deaths, serious harm, or pattern of neglect

3. Office for Civil Rights and Civil Liberties

Online: dhs.gov/file-civil-rights-complaint
Phone: 202-401-1474
Report denial of care, discrimination, conditions

4. Freedom for Immigrants

From detention: Dial 9233#
Free, confidential hotline
They document cases and advocate

5. State Medical Board

If facility doctor is negligent
File complaint with state licensing board

What to Include in Medical Neglect Complaints

[ ] Name and A-Number of affected person
[ ] Facility name and location
[ ] Medical condition(s)
[ ] Dates care was requested
[ ] How requests were made
[ ] Responses received
[ ] Current symptoms/condition
[ ] Medications that should be provided
[ ] Any prior medical records available
[ ] Names of staff involved
[ ] Witnesses

Common Medical Neglect Situations

Chronic Conditions

Diabetes:

Entitled to: Regular blood sugar monitoring, insulin/medications, appropriate diet
Neglect looks like: No monitoring, wrong insulin doses, high-carb only diet, diabetic emergencies

HIV/AIDS:

Entitled to: Antiretroviral medications, regular monitoring, specialist care
Neglect looks like: Medication interruption, no viral load testing, opportunistic infections untreated

Mental Health:

Entitled to: Psychiatric evaluation, medications, counseling
Neglect looks like: Medication discontinuation, no access to psychiatrist, solitary for mental illness

Heart Conditions:

Entitled to: Medications, monitoring, emergency care
Neglect looks like: Withheld heart medications, ignored chest pain, delayed emergency response

Pregnancy

Pregnant detainees are entitled to:

[ ] Prenatal care
[ ] Nutritional support
[ ] Regular monitoring
[ ] Access to OB/GYN
[ ] Hospital delivery
[ ] Post-partum care

Neglect looks like:

No prenatal visits
Ignored pregnancy complications
Inadequate nutrition
Shackling during labor (prohibited)
Delayed hospital transfer

Mental Health Emergencies

Signs of mental health emergency:

Suicidal statements or behavior
Self-harm
Psychotic symptoms
Severe anxiety or panic
Complete inability to function

What should happen:

Immediate mental health evaluation
Suicide watch if appropriate
Psychiatric medication
Transfer to appropriate facility