A tooth extraction performed without anesthesia. An antidepressant discontinued without explanation. Possible heart attack symptoms left without a follow-up.
These are only some examples detailed in a new report by the New York Lawyers for the Public Interest (NYLPI), reviewed by Documented, which found serious deficiencies in medical care provided to detainees in ICE custody at the Orange County Jail in Goshen, New York.
The report highlights patterns of systemic failures in the medical care provided to immigrants held in the county jail, and identifies four main areas of concern: neglect of follow-up care after an illness or injury, lack of care for patients with chronic conditions, restricted access to medication and lack of nutrition and language access.
After analyzing the medical records of 19 detainees who were referred to NYLPI’s Medical Providers Network between January 2022 and May 2024, the authors of the report concluded that “each of these nineteen individuals had critical gaps in their medical care while detained.”
To reach this conclusion, the authors reviewed medical-legal advocacy letters produced in each of the 19 cases by the network’s volunteer doctors. These letters resulted from doctors’ review of medical records which evaluated the adequacy of the care provided to detainees and identified any violations of established medical standards. They were produced following a request from a detainee’s legal counsel.
It is the third report produced by NYLPI on healthcare access in immigration detention facilities in the New York City metropolitan area since 2017, and the first one to focus on the Orange County Jail.
“Consistently, one of the facilities that has some of the highest level of abuses and the highest number of referrals we receive has been the Orange County Jail,” Sophie Dalsimer, co-director of health justice at NYLPI and co-author of the report, told Documented.
Neither the Orange County Sheriff’s office nor ICE replied to a request for comment about the medical care provided at the facility in time for publication.
Among the report’s findings, Julian L. (patients’ full names are withheld from the report), is described as having suffered a stroke at a young age prior to his detention. While detained, he had a cardiac monitor to identify possible heart problems related to the stroke, but he never received the follow-up care necessary to interpret the data collected during his detention, the report states. When Julian L. exhibited symptoms of another stroke, he was not evaluated until weeks later, when he was brought to the hospital after experiencing arm numbness.
According to the report, 10 of the 19 individuals whose medical records were studied required follow-up care that was never provided. In total, the authors discovered 20 separate instances where follow-up care was required but never provided by the detention center staff.
In other cases, patients with chronic illnesses were not provided adequate medical monitoring to manage their conditions. One patient, Camilo P., who was diagnosed with lumbar spondylosis, a progressive degeneration of the spine, was denied access to physical therapy.
“These delays are not just negligent, they put them at real risk for worsening pain, long-term disability, and loss of function,” said Dr. Kate Sugarman, a primary care physician and member of NYLPI’s Medical Providers Network, who reviewed Camilo P.’s medical records. “People want to work, they want to be independent, they want to be able to take care of themselves, but you can see at OCJ [Orange County Jail], they’re getting destined to a life of disability which is completely preventable.”
The report also details several instances in which patients were prescribed sub-therapeutic doses of their medications or denied access to their medications altogether. Camilo P. had to wait nearly three months for a prescription of pain relief medication for his chronic back pain. It is one of several instances of denial of access to pain medication in the report, which also documents the case of Isaac T., who had to undergo a tooth extraction without anesthesia.
In other cases, one patient diagnosed with glaucoma, Felix S., was denied access to his prescription eye drops, putting him at risk for irreversible optic nerve damage or blindness, according to the report. Another patient exhibiting symptoms of a urinary tract infection was denied antibiotics.
A Repeated Pattern
The lack of medical care provided in immigration detention has been a well documented issue across the country. A congressional research service report shows several government reports about medical access in immigration detention facilities have been released in the past ten years by the Department of Homeland Security (DHS), the Office of the Inspector General (OIG) and the Government Accountability Office (GAO).
A 2023 NPR investigation analyzing inspection reports of two dozen detention facilities across 16 states from 2017 to 2019, found that the most consistent problems were related to medical and mental health care. A 2024 report by the American Civil Liberties Union (ACLU) also found that 95% of the deaths that occurred in immigration detention between 2017 and 2021 were preventable or possibly preventable, and pointed to sub-standard medical care as the main underlying issue.
“I think the fact that the violations that we’ve documented have occurred with such consistency suggests that this agency is more than just negligent, but has really been deliberately disregarding the humanity of the people that they detained,” said Dalsimer.
This is not the first time such violations have been reported in Orange County either. The county has contracted with ICE to host immigration detainees since 2008, and has since faced multiple lawsuits. In 2025, the county budgeted $77.6 million for the jail.
In 2016, two former detainees represented by NYLPI sued Orange County alleging that detainees with mental illnesses were not provided with adequate discharge planning. The lawsuit was settled privately in 2019.
In 2023, six ICE detainees filed a lawsuit against Orange County alleging they were retaliated against by the jail after participating in a hunger strike meant to denounce mistreatment, including lack of medical care, in the jail. The case is still ongoing.
Prior to 2025, the medical care at the facility was handled by a subsidiary of Wellpath, one of the country’s largest private prison health providers, which declared bankruptcy in November 2024 while facing multiple lawsuits, including one from the family of a detainee who died in custody at Orange County Jail. Following the company’s bankruptcy, the county has been contracting with YesCare, formerly known as Corizon, another private medical provider who has faced similar lawsuits in other states.
“I think this is so critical now, because all of the problems that we identified as occurring persistently in the past are just being exacerbated at this moment,” said Dalsimer. “Anytime you are adding more strain on a system that is already malfunctioning, there are going to be worse outcomes,” she said.
Since January, as the number of ICE arrests and detentions across the country and the state has soared, so has the number of immigration detainees held in Orange County Jail. According to an analysis of ICE data by New York Focus, the number of immigration detainees at Orange County Jail went from 72 on January 1 to 170 on June 1 — a 136% increase.
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Meanwhile, the Trump administration has effectively shut down oversight bodies within DHS, including the Office of the Immigration Detention Ombudsman, which is responsible for independently examining detention conditions to ensure they are fair and humane.
Nevien Swailmyeen, health justice advocacy manager at NYLPI and co-author of the report, said NYLPI has continued to receive referrals coming from Orange County Jail for medical advocacy through its Medical Providers Network, citing a recent example of a detainee who was denied access to prescription shoes for a chronic foot issue.
Recommandations
In the report, the authors recommend that Orange County hold a public hearing on detention conditions at the Orange County Jail, and that New York City and State pass both the Dignity not Detention Act and the New York for All Act.
你知道吗？非公民办理驾照时的这个错误可能会导致选民欺诈
Swailmyeen also called on healthcare professionals to “join this fight” and advocate for the medical care of ICE detainees. “I think the core understanding here is detention goes against health needs, it exacerbates health, it is unnecessary,” she said.
Ultimately, the report’s main recommendation calls for an end to immigration detention: “The only pathway to ensuring adequate medical care,” the authors write, “is to allow individuals to receive care in their community while awaiting their court hearings.”
Correction October 9, 2025: An earlier version of this article miscited immigrant detainee numbers from the Orange County Jail in Florida and not the Orange County Jail in New York. We regret the error.
