By The United States Government Accountability Office; Rebecca Gambler, et al.

Within the Department of Homeland Security, ICE is responsible for providing safe, secure, and humane confinement for detained noncitizens in the United States. In that capacity, ICE oversees and at some detention facilities provides on-site medical care services. ICE also oversees referrals and pays for off-site medical care when services are not available at detention facilities. GAO was asked to review issues related to informed consent for medical care for noncitizens in immigration detention facilities. Among other things, GAO examined the extent to which ICE has policies for obtaining informed consent for medical care, and how selected facilities implemented the policies; and oversees implementation of policies related to informed consent to help ensure compliance. GAO interviewed ICE officials and medical staff from six facilities selected, in part, based on whether ICE staff provided on-site medical care. GAO also reviewed 48 medical files from these facilities. Further, GAO analyzed oversight results for fiscal years 2019 through 2021, and reviewed ICE documentation in light of federal internal control standards. What GAO Recommends GAO is making three recommendations, including that ICE require detention facilities to collect informed consent documentation from off-site providers, and then require a review of this documentation as part of its oversight mechanisms for detention facilities. The Department of Homeland Security concurred with each of the recommendations.

Washington, DC: GAO, 2022. 53p.

By American Immigration Council

From the document: "The United States has broad authority to detain certain categories of migrants and others seeking humanitarian protection as their proceedings wind their way through the immigration legal system. This detention is 'civil' by definition (as opposed to criminal), meaning that it should not be punitive in nature. Despite this technical legal distinction, most immigration detention infrastructure is indistinguishable from the criminal detention context, in some instances using the same facilities and private corporations to operate detention centers and jails. [...] Alternatives to detention (ATDs) are defined as 'any legislation, policy or practice, formal or informal, that ensures people are not detained for reasons relating to their migration status. Alternatives to detention can refer to a wide range of programs that run the gamut from no governmental intervention to extensive surveillance and restrictions on liberties. Generally, alternatives to detention in the immigration context fall into the following categories: 1. Release on your own recognizance (i.e., no detention and no conditions on release)[;] 2. Release on conditions[;] 3. Release on bail/bond or other surety[;] 4. Community-based supervised release or case management[;] 5. Designated residence at a specific accommodation center[;] 6. Electronic tagging and/or tracking[;] 7. Home curfews[.]"

American Immigration Council. 2023. 10p.

By Transnational Records Access Clearinghouse

In this report, TRAC examines the growth of ATD during the first year of the Biden administration using detailed data obtained from ICE through Freedom of Information Act (FOIA) requests. These data on ICE’s ATD program are not the most current. As TRAC recently announced, by the end of September 2022 the number of people in ATD exceeded 300,000 for the first time. Nonetheless, the data in this report provide a far more detailed picture than ICE’s regular ATD releases.

Syracuse, NY: Transactional Records Access Clearinghouse, 2022.

By Human Rights Watch

As the harmful effects of immigration detention become more widely known and the appropriateness of detaining migrants is increasingly questioned, governments are looking at alternatives to detention as more humane and rights-respecting approaches to addressing the management of migrants and asylum seekers with unsettled legal status. This report examines alternatives to immigration detention in six countries: Bulgaria, Canada, Republic of Cyprus, Spain, the United Kingdom, and the United States to highlight viable, successful alternatives that countries should implement before resorting to detention. While the report provides an analysis of specific alternatives to detention (often referred to as ATDs) in each country, it is not intended to provide a comprehensive overview of all alternative programs available.

Each country featured in this report has taken a different approach to alternatives to detention. Some focus more heavily on surveillance and others on a more person-centered, holistic approach. Ultimately, this report finds alternatives that place the basic needs and dignity of migrants at the forefront of policy, such as community-based case management programs, offer a rights-respecting alternative to detention while simultaneously furthering governments’ legitimate immigration enforcement aims.

New York: HRW, 2021. 103p.