Minnesota is obligated to provide adequate health care to people who are incarcerated; here’s some first steps

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In review of the operations of Kandiyohi and Freeborn County jails in August and September of 2020, the ICE Office of Detention Oversight identified numerous compliance violations that place detainees at risk and violate Minnesota law. (See here for Kandiyohi. And here for Freeborn.)

They found that detention officers without medical training were completing the facility’s medical, dental and mental health screenings. They also noted that despite having phone interpreter services available, interpreters were not used during medical evaluations of detainees with limited English proficiency. They discovered cases of detainees being given medical care or even psychotropic medications without consent. Despite these and other compliance failures, neither ICE nor the Minnesota Department of Corrections took corrective actions, highlighting the lack of accountability in Minnesota’s jails, even in the face of egregious violations.

We applaud the Minneapolis City Council for passing a resolution highlighting the COVID-19 pandemic’s effect on Minnesotans held in ICE detention. We also commend the efforts of the criminal justice system to decrease jail crowding and encourage the continuation of early release and alternative sentencing within both the criminal justice and immigration detention systems to further prevent the spread of COVID-19. Mass incarceration must end, and until it does, we strongly urge state officials and ICE to take two immediate steps necessary to ensure the health and well-being of those detained:  

1. Timely and equitable vaccine access to incarcerated people in Minnesota.

2. Establishment of an independent medical oversight mechanism in Minnesota to ensure the quality of health care provided to all incarcerated people.

As evidenced by recent outbreaks in Minnesota’s jails and prisons, congregate settings create prime opportunities for COVID-19 spread. As such, we see an opportunity to reduce transmission of COVID-19 in Minnesota by immediately offering vaccination to incarcerated Minnesotans.

Counties don’t have independent medical oversight, but the ICE reports on the state of detention in Minnesota shows why the state urgently needs it to ensure the physical safety of those who are incarcerated.

In Minnesota, there are no stand-alone ICE detention centers. Instead, Kandiyohi, Freeborn, Sherburne, Carver and Nobles counties have direct contracts with ICE to detain immigrants within their county jails. Each county has its own plan for medical care within their jail, and there is limited oversight of the care provided. Kandiyohi county, for example, contracts with a private health care company called MeND which is currently under investigation by the Minnesota Board of Medical Practice for violations of medical ethics.  

Since Thanksgiving, there has been a severe COVID-19 outbreak at the Kandiyohi County jail.The outbreak has spread throughout the ICE detainee population, with nearly three full units testing positive. According to attorneys representing detainees at Kandiyohi, the detainees themselves and ICE’s own evaluation, the health care provided to ICE detainees in Minnesota falls short of even basic quality standards. 

According to current detainees at Kandiyohi, an ICE detainee who was negative for COVID-19 was knowingly placed in a cell with another detainee who was COVID positive, in violation of ICE guidelines. No meaningful medical evaluation has been completed on detainees with COVID-19 aside from daily temperature checks. No pulse oximetry has been offered, and anxious detainees — including ones at heightened risk of serious illness — remain in the dark without access to a doctor and with limited to no access to accurate COVID-19 health information. Additionally, ICE detainees have reported feeling afraid of reporting symptoms to jail staff, because they are unlikely to receive care and would instead be placed in isolation — conditions equivalent to solitary confinement or punitive segregation. 

The failure to provide competent health care during this pandemic places the health and well-being of incarcerated people at significant risk, and in some cases violates basic rules of medical ethics; the current lack of accountability allows this to continue. We therefore call for the immediate establishment of an independent medical oversight mechanism for the care of incarcerated people in Minnesota.

Given the ongoing rise in cases and spread of a more virulent strain of COVID-19, the time to act is now.

Hannah Lichtsinn
Dr. Hannah Lichtsinn is a primary care internist and pediatrician in Minneapolis and an assistant professor of medicine at the University of Minnesota. She is a co-founder of the Minnesota Immigrant Health Alliance and co-chair of the health advocacy organization, Our Stories. Our Health.
Calla Brown
Dr. Calla Brown is an assistant professor of pediatrics at the University of Minnesota and a primary care physician at a community health center in the Twin Cities. She is a co-founder of the Minnesota Immigrant Health Alliance.
Kathleen Moccio
Kathleen Moccio is an attorney and assistant visiting clinical professor at the James H. Binger Center for New Americans, University of Minnesota Law School. She has over 30 years of experience as an immigration attorney and frequently speaks and writes on immigration issues.