ICE Works Hard to Provide Health Care to Detainees

Providing quality health care to detainees in U.S. Immigration and Customs Enforcement's (ICE) custody is an important and challenging task — one that Assistant Director for ICE Health Service Corps (IHSC) Dr. Jon Krohmer takes very seriously.

The ICE Office of Enforcement and Removal Operations (ERO) ensures the safe and humane conditions of confinement for aliens detained in ICE custody. This includes the provision of reliable, consistent and appropriate health services. IHSC, which falls under ERO, is comprised of more than 900 Public Health Service-commissioned officers, federal civil servants and contract support staff. Their mission is straightforward: to serve as the medical authority for ICE on a wide range of medical issues, including the agency's comprehensive detainee health care program.

IHSC provides direct care to approximately 15,000 detainees housed at 21 IHSC-designated facilities throughout the nation. In addition, IHSC oversees the medical care provided to an additional 17,000 detainees at non-IHSC staffed detention facilities across the country. Whenever necessary, it authorizes and pays for off-site specialty and emergency care, consultations and case management.

"A detainee's health care begins the moment they walk through the facility's doors," said Dr. Krohmer. "Within the first 12 hours of their admission, all detainees undergo a preliminary health screening, which includes an evaluation of the individual's medical, dental and mental health status and within the next 14 days, a more detailed physical examination takes place."

Because so many of these detainees are either new arrivals in the country or haven't had access to health care in the past, Dr. Krohmer said it is not unusual for serious health problems to be diagnosed at these screenings.

"We're finding out about health issues that even they didn't even know about and in most cases are able to begin treatment," he said.

This continuity of care not only lasts during the individual's period of detention, but also throughout their removal to their country of origin. Before any detainee boards a plane to be removed from the United States, they must first undergo an evaluation to make sure they are fit to fly.

In order to continually upgrade the quality of medical services they deliver, IHSC not only actively complies with the Performance Based National Detention Standards, but is also instrumental in the standard's continuous upgrades and improvements. Dr. Krohmer said that over the last few years, IHSC has become much more involved in their development and revisions.

"My staff and I are aware that detainee health care is an ever-evolving issue and that just like in the general population, health care priorities are constantly changing," said Dr. Krohmer. "We are working to develop a more systematic approach to our health care system within the detention facilities."

For instance, ICE recently streamlined the treatment authorization request. This application — used to formally request a specialized medical procedure that falls outside the scope of what IHSC can provide — is now typically reviewed and approved within 24 hours.

Krohmer added that plans are underway to forge a more uniform health care system among the IHSC facilities, enabling them to work together more cohesively.