When it comes to INS, let contractor beware
When it comes to INS, let contractor beware
Per diem brings host of potential problems
Prisons and jails that house people detained by the Immigration and Naturalization Service (INS) had better be ready for whatever comes their way, says Geralyn Johnson, DDS, MPH, chief of clinical operations at INS headquarters in Washington, DC.
What might that include? Here’s Johnson’s inventory: detainees who have left staging centers without their medical records, detainees whose chest X-rays have been misread by rushed radiologists, and detainees with active TB who either lie about TB symptoms or don’t have any visible symptoms of the disease.
"We probably get everything right at least 50,000 times, maybe even 100,000 times, to the one instance where we make a mistake," she says. But given the volume of cases, "we probably screw up several times a day."
The INS detains a million and a half people every year, with about 20,000 in custody on any given day. The enormous number of people making their way through the system means that detainees often are moved out to "contract facilities" — the hundreds of prisons and jails across the country that are paid $30 to $60 a day to house the overflow of detainees. This can happen long before their medical screenings have been completed, says Johnson.
Things should improve by the end of the year, when the INS hopes to have its new digitized chest X-ray system up and running. That should shrink the screening period from four to five days to about four hours, she adds. In the meantime, Johnson notes, contract facilities should beware.
Of the 20,000 people held in detention every day, about 5,000 are taken to an INS service processing center. The centers are equipped with beds, meaning that detainees routed there can often stay put until their TB screening is finished.
The remaining 15,000 detainees wind up at an INS staging center, where there are no beds. By nightfall, those detainees probably have been taken through an initial symptom screening; that is, someone has asked them about TB symptoms and whether they’ve been treated for TB in the past. Also at that stage, someone will check them visually for signs of TB, Johnson says.
But come night, those detainees must go somewhere else, either to a service processing center, if any beds are available, or more likely to an INS jail or prison contract facility.
As for medical records, Johnson admits that detainees and records often get separated. The subject is the cause for much effort and soul-searching at the INS, she adds. "We’ve tried everything we can think of" to keep it from happening, she says, without much success. If detainees show up without medical records, the contract facility at the other end had better do what’s good for it, she concludes — put them into isolation.
"The INS isn’t really in the business of detaining people," she adds. "Our goal is to move people, either into this country if they have correct documentation, or out if they don’t." What’s complicated the situation and created the severe bed shortage that’s led to the use of contract facilities is a pair of laws passed in the last decade, she says.
One law ensures that detainees get the right to legal counsel before they’re deported. The other prevents detainees who have been convicted of a crime, and then served their time, from being released into the community. Instead, the law says, they must be deported.
The Catch-22 is that usually, the detainees’ country of origin doesn’t want them back if they’ve committed a crime. Soon, Johnson estimates, some 80% of INS detainees will consist of ex-criminals stuck in legal limbo.
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