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

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

But local public health officials who routinely inspect county jails and state prisons say they are not authorized by state law to inspect detention centers run by private companies, including all six federal immigration centers in California.

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

Durazo said many inmates live in substandard conditions and that infectious diseases sweeping through these facilities can pose a risk to surrounding communities.

“Unfortunately, our prisoners are treated as if they are not human,” she said. “We don’t want any excuses. We want state and public health authorities to step in whenever necessary.”

It’s not clear how much authority local health officials would have to implement changes, but public health experts say they could serve as independent observers documenting 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.

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

During the 2020 campaign, President Joe Biden pledged to end for-profit immigration detention. But more than 90% of the roughly 30,000 people detained by U.S. Immigration and Customs Enforcement on any given day remain in private facilities, according to a 2023 analysis by the American Civil Liberties Union. Members of Congress 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.

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

In 2019, California Governor 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 applied 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 and occupational safety and health regulations. That measure was enacted at the height of the Covid-19 pandemic, as the virus tore through detention facilities where people were packed into dormitories with little or no protection against airborne viruses.

For example, at the Otay Mesa Detention Center in San Diego, an outbreak early in the pandemic infected more than 300 staff and inmates.

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

“These investigations play a critical role in identifying and addressing health and sanitation issues within these facilities, thereby reducing risks to inmates, staff and the surrounding communities,” according to a letter from the association’s executive director, Kat DeBurgh.

Under the measure, public health officials would determine whether facilities comply with environmental regulations, 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 officials inspect annually, private detention facilities would be inspected as needed, as determined by the health officer.

GEO Group spokesman Christopher Ferreira and ICE spokesman Richard Beam declined to comment on the action.

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

While they likely cannot compel detention centers to follow their recommendations, their reports can provide valuable information for public officials, lawyers and others who want to pursue alternatives such as litigation, he said. “When the system doesn’t work, the courts can play a very profound role,” Benjamin said.

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

Detention inspections are typically conducted by ICE employees and 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 happens in detention centers that we can’t document,” Dekker said.

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

Recent lawsuits by inmates allege cramped and unsanitary conditions, denial of adequate mental and medical health care, medical negligence and wrongful death by suicide.

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

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

Lovos, who was born in El Salvador and uses the pronoun 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 inmates from the Golden State Annex and Mesa Verde ICE Processing Center in Bakersfield began a work and hunger strike demanding an end to poor living conditions, solitary confinement and inadequate medical and mental health services.

Lovos described a crowded dormitory, clogged air filters, mice and cockroaches scurrying in the kitchen, water leaking from the ceiling and inmates with flu-like symptoms unable to access medication or a covid test upon request.

ICE protocol requires testing of inmates with symptoms upon admission to facilities with no Covid hospitalizations or deaths in the previous week. At facilities with two or more hospitalizations or deaths in the previous week, all detainees are tested during admission. It is up to each clinic’s medical providers to decide when a test is necessary after that.

After the Lovos filed a complaint with GEO Group in June, alleging medical and mental health neglect, they said they were placed in solitary confinement for 20 days without a functioning toilet. “I could smell my urine and feces because I couldn’t flush.”

Ferreira declined to address Lovo’s allegations but said via email that inmates receive “24/7 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 that Golden State Annex employees did not respond within 24 hours to medical complaints, which the report said could adversely affect inmate health, and did not properly store inmate medical records.

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

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

This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

This article was reprinted from khn.orga national newsroom that produces in-depth journalism on health issues and is one of KFF’s core business programs – the independent source for health policy research, opinion polls and journalism.