By Vanessa G. Sánchez | KFF Health News

Covid-19, mumps and chickenpox outbreaks. Contaminated water, moldy food and air ducts spewing black dust.

These health threats have been documented inside privately run immigration detention facilities in California through lawsuits, federal and state audits, and complaints lodged by detainees themselves.

But local public health officers who routinely inspect county jails and state prisons say they don’t have the authority under state law to inspect detention centers operated by private companies, including all six federal immigration centers in California.

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State Sen. María Elena Durazo (D-Los Angeles) wants to close that loophole with legislation that would allow county health officers to conduct inspections at the facilities if health officers deem them necessary.

Durazo said that many detainees live in substandard conditions and that communicable diseases sweeping through these facilities could pose a risk to surrounding communities.

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“Unfortunately, our detainees are treated as if they’re not human beings,” she said. “We don’t want any excuses. We want state and public health officials to go in whenever it’s needed.”

It’s not clear how much authority local health officers would have to implement changes, but public health experts say they could act as independent observers who document violations that would otherwise remain unknown to the public.

The state Senate passed the bill, SB 1132, unanimously in late May. It is now under consideration in the state Assembly.

Also see: Detainee who pleaded for release from ICE immigration center in Adelanto dies from COVID-19

Immigration is regulated by the federal government. GEO Group, the country’s largest private prison contractor, runs California’s federal centers, located in four counties. Together they can house up to 6,500 people awaiting deportation or immigration hearings.

While campaigning in 2020, President Joe Biden pledged to end for-profit immigration detention. But more than 90% of the roughly 30,000 people held by the U.S. Immigration and Customs Enforcement agency on any given day remain in private facilities, according to a 2023 analysis by the American Civil Liberties Union. Congress members in both chambers have introduced legislation to phase out private detention centers, while other lawmakers, including at least two this month, have called for investigations into substandard medical and mental health care and deaths.

Lawmakers in Washington state passed a law in 2023 to impose state oversight of private detention facilities, but the GEO Group sued and the measure is tied up in court. California lawmakers have repeatedly attempted to regulate such facilities, with mixed results.

In 2019, California Gov. Gavin Newsom, a Democrat, signed a measure banning private prisons and detention facilities from operating in California. But a federal court later declared the law unconstitutional as it related to immigration detention centers, saying it interfered with federal functions.

In 2021, state lawmakers passed a bill requiring private detention centers to comply with state and local public health orders and worker safety and health regulations. That measure was adopted at the height of the covid-19 pandemic, as the virus tore through detention facilities where people were packed into dorms with little or no protection from airborne viruses.

For instance, at the Otay Mesa Detention Center in San Diego, one outbreak at the start of the pandemic infected more than 300 staff members and detainees.

The Health Officers Association of California, which represents the public health officers for the state’s 61 local health departments, supports Durazo’s legislation.

“These investigations play a pivotal role in identifying and addressing health and sanitary concerns within these facilities, thereby mitigating risks to detainees, staff, and the surrounding communities,” according to a letter from the association’s executive director, Kat DeBurgh.

Under the measure, public health officers would determine whether the facilities are complying with environmental rules, such as ensuring proper ventilation, and offering basic mental and health care, emergency treatment, and safely prepared food.

Unlike public correctional facilities, which local health officers inspect every year, private detention centers would be inspected as needed, to be determined by the health officer.

GEO Group spokesperson Christopher Ferreira and ICE spokesperson Richard Beam declined to comment on the measure.

American Public Health Association Executive Director Georges Benjamin said public health officers are well positioned to inspect these facilities because they understand how to make confined spaces safer for large populations.

Even though they likely can’t force the detention centers to comply with their recommendations, their reports could provide valuable information for public officials, attorneys, and others who want to pursue options such as litigation, he said. “When the system isn’t working, the courts can play a very profound role,” Benjamin said.

The federal system that monitors health care and the transmission of communicable diseases inside immigration detention centers is broken, said Annette Dekker, an assistant clinical professor of emergency medicine at UCLA, who studies health care in these facilities.

Inspections of detention centers are typically conducted by ICE employees and, up until 2022, by a private auditor. In a paper published in June, Dekker and other researchers showed that immigration officials and the auditor conducted inspections infrequently — at least once every three years — and provided limited public information about deficiencies and how they were addressed.

“There’s a lot of harm that is happening in detention centers that we are not able to document,” Dekker said.

ICE and the GEO Group have been the subjects of lawsuits and hundreds of complaints alleging poor conditions inside the California facilities since the pandemic began. Some of these lawsuits are pending, but a significant share of complaints have been dismissed, according to a database maintained by the American Civil Liberties Union.

The most recent lawsuits by detainees allege crowded and unsanitary conditions, denial of adequate mental and medical health care, medical neglect, and wrongful death by suicide.

The California Division of Occupational Safety and Health fined the GEO Group about $100,000 in 2022 for failing to maintain written procedures to reduce exposure to covid. The GEO Group has contested the fine.

“I have experienced really inhumane living conditions,” 28-year-old Dilmer Lovos told California Healthline by phone from the Golden State Annex immigration detention center in McFarland, Kern County. Lovos has been held there since January while awaiting an immigration hearing.

Lovos, who was born in El Salvador and uses the pronouns they/them, has been a legal permanent resident for 15 years and was detained by immigration officials while on parole.

In early July, Lovos and 58 other detainees from Golden State Annex and the Mesa Verde ICE Processing Center in Bakersfield started a labor and hunger strike demanding the end of poor living conditions, solitary confinement, and inadequate medical and mental health services.

Lovos described a packed dorm room, clogged air filters, mice and cockroaches scurrying in the kitchen, water leaking from the ceiling, and detainees with flu-like symptoms who couldn’t get access to medication or a covid test when requested.

ICE protocols require testing of detainees with symptoms upon intake into facilities with no covid hospitalizations or deaths in the previous week. In facilities with two or more hospitalizations or deaths in the previous week, all detainees are tested during intake. It is up to each facility’s medical providers to decide when a test is necessary after that.

After Lovos filed a complaint with the GEO Group in June, alleging medical and mental health neglect, they said they were placed in solitary confinement for 20 days without a properly functioning toilet. “I was smelling my urine and feces because I was not able to flush.”

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Ferreira declined to address Lovos’ allegations but said via email that detainees receive “around-the-clock access to medical care,” including doctors, dentists, psychologists, and referrals to off-site specialists.

“GEO takes exception to the unsubstantiated allegations that have been made regarding access to health care services at GEO-contracted ICE Processing Centers,” he said.

An unannounced inspection by federal immigration officials in April 2023 found Golden State Annex employees did not respond within 24 hours to medical complaints, which the report said could negatively affect detainees’ health, and did not properly store detainees’ medical records.

Lovos said that no one has addressed their concerns and that conditions have only worsened.

“Please come check these places out,” Lovos said in a plea to local health officials.

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.