Orange County Jail Faces Renewed Allegations of Shoddy Medical Care

(GOSHEN, NEW YORK) New York’s largest ICE detention facility, the Orange County Jail in Goshen, is under renewed scrutiny after a fresh report alleged severe and systemic medical care deficiencies for immigrants held there, citing cases of untreated strokes, delayed medications, and even a tooth extraction without anesthesia. The 68-page review by the New York Lawyers for the Public Interest (NYLPI), released in October 2025, draws on medical records and advocacy letters for 19 detainees between January 2022 and May 2024 and documents what it describes as critical gaps in care, denial of medication, lack of follow-up for serious conditions, and preventable suffering.

The report’s cases are concrete and stark. Julian L., a detainee with a prior stroke, was placed on a cardiac monitor in custody—yet never received follow-up care to interpret the data. Later, when he showed symptoms of another stroke, he was not evaluated until weeks had passed, only after arm numbness forced a hospital trip. Another detainee, identified as Isaac T., had a tooth pulled without anesthesia. In other instances, a patient with urinary tract infection symptoms was denied antibiotics, and a man diagnosed with glaucoma, Felix S., was refused prescription eye drops, a decision that risked irreversible damage to his optic nerve and potential blindness. Together, the cases paint a picture of ICE detention at the Orange County Jail marked by medical care deficiencies that advocates say are both avoidable and dangerous.

For people living with chronic conditions, the report details prolonged delays and blocked access to treatment. One detainee, Camilo P., who was diagnosed with lumbar spondylosis, a degenerative spine condition, was denied physical therapy and waited nearly three months for pain relief medication to be provided. Reviewing his records, Dr. Kate Sugarman, a primary care physician and member of NYLPI’s Medical Providers Network, said:

“These delays are not just negligent, they put them at real risk for worsening pain, long-term disability, and loss of function. 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 study’s numbers point to a pattern, not a series of outliers. Of the 19 detainees whose cases were reviewed, 10 required follow-up care that was never provided. Across those files, NYLPI found 20 separate instances where follow-up treatment was needed and simply did not happen. Advocates argue that the failures—lack of specialist referrals, halted medications, missed diagnostic reviews, and ignored warning signs—undermine the basic duty of care for people in custody, some of whom entered confinement with known conditions that require consistent management.

The Orange County Jail has contracted with U.S. Immigration and Customs Enforcement since 2008 and remains a key hub in ICE detention in the state. According to the report, the county in 2025 budgeted $77.6 million for the jail. NYLPI notes that this is the first study it has released focused specifically on the Orange County Jail but follows two earlier reports the organization published on other New York-area ICE detention facilities since 2017. The group’s latest review identifies four recurring areas of concern inside the Goshen jail: neglect of follow-up care after illness or injury; lack of care for chronic conditions; restricted access to medication; and lack of adequate nutrition and language access.

Sophie Dalsimer, co-director of health justice at NYLPI and a co-author of the report, said the organization’s casework and monitoring consistently point back to the Goshen facility.

“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.”

She added:

“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.”

NYLPI’s account stands out because it is anchored in individual medical records and the day-to-day experiences of detainees rather than broad claims about the system. In ICE detention, medical care deficiencies often revolve around missed follow-up appointments, late or interrupted medications, and delays in emergency responses. In Goshen, the records describe precisely those fault lines: a heart monitor with no interpretation; a suspected stroke not clinically evaluated until weeks later; pain management for a spine condition postponed for months; glaucoma medication refused despite known risks; and a dental procedure conducted without anesthesia. For immigrant detainees living inside the jail, advocates argue, these are not mere administrative slip-ups but choices with direct and sometimes irreversible health consequences.

Officials at the Orange County Sheriff’s office and ICE did not respond to requests for comment about the facility’s medical care in time for publication, leaving questions about how the jail and the agency plan to address the specific cases raised in the report. The facility has faced multiple lawsuits over medical care since it began housing ICE detainees, according to NYLPI, but the report does not detail the outcomes of those lawsuits. As of November 2025, the jail remains under contract with ICE and continues to detain immigrants amid mounting evidence and litigation that allege dangerously inadequate medical care.

The allegations in Goshen sit within a broader national pattern documented by civil rights groups, journalists, and lawmakers. A 2024 report by the ACLU, Physicians for Human Rights, and American Oversight concluded that over 90% of deaths in ICE custody could have been prevented with better medical care. Those findings included incorrect diagnoses, delays during emergencies, and the outright denial of needed medications. Separately, a 2023 NPR investigation and a 2025 U.S. Senate investigation led by Sen. Jon Ossoff found systemic failures in medical and mental health care across ICE detention centers, including delays in care that proved life-threatening, denial of medication, and inadequate food and water. The converging conclusions from these sources reinforce concerns that the problems in Goshen are not isolated but reflect deeper systemic weaknesses in how health care is delivered in immigration detention.

ICE publishes national detention standards that set expectations for medical and mental health services inside facilities that hold immigration detainees. Those standards spell out requirements for screenings, access to medications, emergency responses, and follow-up care. But the NYLPI report suggests that in practice, at least at the Orange County Jail, those provisions are not translating into consistent care for people in custody. The agency’s standards can be found on ICE’s official website, including the Performance-Based National Detention Standards, which outline medical care requirements and oversight mechanisms for contracted facilities such as the one in Goshen. For readers seeking the baseline rules that should govern facilities like Orange County Jail, the standards are available at the ICE detention standards page.

At the center of the NYLPI report are the lived consequences of institutional decisions: the person who waited weeks for a possible stroke to be assessed; the man who went months without pain medication; the detainee whose tooth extraction happened without anesthesia; and the patient whose glaucoma medication was withheld despite the risk of permanent vision loss. The organization’s framing is that while detention is meant to be civil, not punitive, the medical care described in these cases has crossed into harm by omission—leaving detainees to endure preventable pain, declining health, and in some instances, heightened risk of long-term disability.

For those with chronic illnesses, continuity of care is essential. The report flags how gaps in follow-up visits, interruptions to medications, and the absence of specialist referrals can compound problems for people with conditions such as cardiovascular disease, glaucoma, and degenerative spine disorders. In the case of Camilo P., access to physical therapy—a standard, noninvasive treatment for lumbar spondylosis—was denied outright. Meanwhile, his pain relief medication, a basic intervention to preserve function and mobility, was withheld for nearly three months. Dr. Sugarman said:

“These delays are not just negligent, they put them at real risk for worsening pain, long-term disability, and loss of function. 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,”

underscoring how policy choices and clinical delays can shape the futures of those detained.

The report’s authors also point to nutrition and language access as compounding factors in poor health outcomes. While the details in individual cases vary, advocates argue that limited access to appropriate diets and inadequate language support can make it harder for detainees to convey symptoms clearly, follow treatment plans, or understand medication changes. In a system where many detainees are held far from family support and where English may not be a primary language, the lack of interpreters and culturally appropriate care can deepen isolation and delay timely interventions when symptoms change or worsen.

NYLPI’s team emphasizes that the pattern they describe—20 missed follow-ups across 19 detainees, with 10 individuals left without needed aftercare—should be viewed against the backdrop of the jail’s long-standing role in New York’s detention landscape and its sizable public funding. The Orange County Jail’s $77.6 million budget in 2025 underscores, in the advocates’ view, a gap between resources and outcomes. The group argues that the consistency of failures across cases suggests not random error but a systemic approach that deprioritizes detainee health and ignores repeated red flags.

At the same time, the report acknowledges the difficulty of obtaining comprehensive information in restrictive environments. Advocates often rely on limited medical records, detainee accounts, and intermittent correspondence with facility health staff to piece together clinical timelines. Even so, the records gathered here, dated between January 2022 and May 2024, present a coherent picture of requests for care followed by long waits, urgent symptoms met with delay, and clinical decisions that appear out of step with basic standards of care. The authors’ contention is that better oversight—internal and external—could address many of these shortfalls, but they also note that, as of November 2025, there have been no substantial changes or official responses indicating a shift in practice at the jail.

The lack of response from ICE and the Orange County Sheriff’s office leaves a vacuum where accountability steps might otherwise be outlined: reviews of clinical protocols, corrective action plans, or changes in contractor performance management. Facilities that hold immigration detainees are expected to meet federal standards, submit to inspections, and resolve deficiencies identified by monitors. Yet the persistence of the same categories of problems—delayed follow-up, withheld medication, and limited chronic care—mirrors national investigations and suggests that jail-level fixes alone may not be sufficient without stronger enforcement and consequences across the detention system.

For families and communities watching from the outside, the allegations carry a human toll beyond the jail walls. When a detainee’s stroke symptoms go unchecked, or when basic pain treatment is delayed for months, loved ones often learn after the fact, through hurried calls or second-hand updates. Some detainees at Orange County Jail may be awaiting immigration hearings or transfers, their legal cases moving forward even as their health deteriorates. Advocates point out that poor medical care can affect the ability to participate fully in one’s legal defense, whether because of pain, impaired vision, or untreated complications that sap energy and attention.

The NYLPI report frames the stakes squarely in moral terms.

“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,” Dalsimer said, describing a steady stream of complaints and referrals to the organization from Goshen.

She added:

“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.”

The repetition of the same failures, across different medical conditions and over multiple months, is presented not as an accumulation of minor errors but as a sign of deliberate indifference to detainee health.

As calls for reform continue, the core questions remain straightforward: Will detainees at the Orange County Jail receive timely diagnoses, needed medications, and appropriate follow-up care? Will oversight bodies enforce the standards on the books? And will ICE, which relies on county jails to hold people in civil custody, ensure that contract facilities adhere to the rules meant to protect those in their care? Without answers from the agencies, the report’s detailed accounts—of a heart monitor never reviewed, a delayed stroke evaluation, glaucoma drops denied, a tooth pulled without anesthesia—stand as the latest, and one of the most pointed, pieces of evidence that the Orange County Jail’s approach to health care is failing the people it holds.

For now, the facility remains a central node in New York’s ICE detention network. The NYLPI report adds measurable, documented cases to a growing national record of medical care deficiencies in immigration detention, echoing the findings of civil society groups, journalists, and the U.S. Senate. Whether those records prompt change at the Orange County Jail—or across the country’s patchwork of detention sites—will depend on institutional responses that have yet to arrive.