Texas facilities: Families report water shortages and delayed care

Parents and children held in two Texas immigration facility sites are reporting a basic failure of care: clean water and timely medical attention. Attorneys and child-welfare monitors say conditions at the South Texas Family Residential Center (Dilley) and the Karnes County Immigration Processing Center (Karnes) mirror the humanitarian problems that prompted the United States to wind down family detention in 2021—only now, the system is expanding again under President Trump.

The accounts, gathered since March 2025 and filed in federal court, include descriptions of a water access crisis so severe that adults have been seen “fighting children for access to clean water,” as well as repeated complaints of delayed or inadequate pediatric care. These reports sit at the center of a mounting legal clash over the Flores Settlement Agreement (1997), the consent decree that sets minimum standards for children in federal custody.

Facilities, capacity, and reopening

• The two facilities are operated by private prison firms: CoreCivic (Dilley) and GEO Group (Karnes).
• As of June 2025:
  • Dilley can hold up to 2,400 parents and children, making it the largest family detention site nationally when at full capacity.
  • Karnes maintains 830 beds.
• In early June 2025 Dilley’s census was about 300 people, with two of five residential areas open, according to immigration attorney Leecia Welch.
  • Welch cautioned that “With a capacity of around 2,400, it’s hard to imagine what it would be like with 2,000 more people.”
• Advocates warn the return of large-scale family detention, combined with weakened oversight, will magnify risks already evident in the first months of renewed operations.

Reported failures: water and medical care

Multiple advocacy groups compiled the reports: the National Center for Youth Law, the Center for Human Rights and Constitutional Law, RAICES, and Children’s Rights. Their findings include:

• Repeated breakdowns in access to potable water:
  • Families reported rationing and confusion about safe water sources.
  • Attorneys documented desperate scenes of adults and children scrambling for clean drinking water.
• Systemic issues in clinical assessment and pediatric care:
  • A child who fell was reportedly denied a full concussion evaluation.
  • A 12-year-old with swollen feet was told only to rest, without proper diagnostic work-up.
  • Clinicians describe lingering ailments from facility care as “Dilley-ish,” pointing to systematic healthcare problems.
• Historical concerns persist: hospitals previously flagged inadequate treatment at Dilley, and in 2018 19‑month‑old Mariee died after leaving the facility—an event still haunting clinicians and families.

These are not isolated complaints, advocates say. They argue the accounts reflect systemic problems raised repeatedly in client interviews and sworn declarations prepared for court.

Why water access is critical

• Water is a non-negotiable health need for children. In hot South Texas months, dehydration and heat stress can escalate rapidly.
• Medical monitors note that young children dehydrate faster than adults and can deteriorate in a matter of hours without safe fluids.
• In detention settings, families cannot simply buy bottled water or leave the facility; they depend entirely on operators and government oversight to maintain safe, constant access.

Conditions inside Dilley and Karnes

Dilley:
– Located on more than 50 acres of South Texas scrubland.
– Families assigned to 80 small, tan two‑bedroom cottages, grouped into five “neighborhoods.”
– Each cottage holds up to eight people with bunk beds and cribs.
– Features like soccer fields and basketball courts exist, but Dilley is a secured facility with tall fencing, controlled movement, and guard posts.
– Cooking is banned for fire safety, so families are fully dependent on the facility for meals and drinkable water—heightening risk when supply or quality fails.

Karnes:
– About 60 miles southeast of San Antonio on 29 acres.
– Interconnected concrete block buildings around small courtyards; rooms include bunk beds, private bathrooms, TV, and microwave.
– The layout is efficient and almost barrack-like, but monitors say efficiency does not solve poor access to health care or limits on daily movement.
– Parents report trouble getting appointments and follow-up visits for chronic conditions, and delays that would be unacceptable in pediatric clinics.

Legal fight over Flores and recent government actions

• The Flores Settlement (1997) requires children in federal custody be housed in settings that are safe, sanitary, and child-welfare oriented, and calls for prompt release to family where possible.
• On April 12, 2025, the Department of Justice moved to end court supervision under Flores, arguing that updated Family Residential Standards can govern care without the decree’s oversight.
• Immigration attorneys filed an opposition on June 20, 2025, citing eyewitness accounts and medical records from Dilley and Karnes to show ongoing failures in sanitation, nutrition, and medical access.
• Central attorney argument: terminating Flores would eliminate the independent check that allows monitoring and public pressure for compliance, enabling longer confinement of families with less transparency.

Legislative backdrop and enforcement expansion

• On July 4, 2025, President Trump signed a tax and immigration package directing $45 billion over four years to grow detention capacity—advocates say this roughly triples spending on detention.
• The measure:
  • Allows indefinite detention of families while cases proceed.
  • Lets facilities operate with or without state or local licensing.
• Advocates warn removing licensing and inspections eliminates key safeguards, especially vital when facilities house infants, toddlers, and school-age children requiring specialized care.
• Arrest targets are rising: White House deputy chief of staff Stephen Miller said ICE agents would aim for at least 3,000 arrests per day, up from about 650 daily earlier in the term.
  • That target, plus broader arrest locations and categories, is expected to send far more families into custody, straining facilities already reporting water and healthcare shortages.

Oversight structures and gaps

Existing ICE oversight:
– Each field office has a Field Office Juvenile Coordinator.
– Each facility has a compliance officer.
– ICE’s Juvenile and Family Residential Management Unit conducts monthly inspections and annual extended reviews.

Gaps and concerns:
– Monitor findings are not routinely public.
– The administration has effectively shuttered federal civil rights offices that once tracked complaints in real time.
– DHS’s Office for Civil Rights and Civil Liberties has reportedly halted more than 500 open investigations.
– Limited access for outside lawyers and pediatric specialists leaves families with fewer avenues to raise concerns.

For a reference to the standards ICE says it follows, see: ICE Family Residential Standards

Health fallout and pediatric concerns

• A comprehensive study of Karnes found inappropriate screening and follow-up for chronic illness, malnutrition, tuberculosis, and mental health needs.
• Pediatric groups assert: “there is no humane way to detain children and no version of family detention that is acceptable.”
• The American Academy of Pediatrics (AAP) emphasizes children’s unique needs and calls for pediatric monitors with child-welfare expertise.
• Mental-health harms tied to family detention include post-traumatic stress, depression, anxiety, and weight loss—even short stays can worsen existing trauma.
• The 2016 DHS Advisory Committee on Family Residential Centers produced a 159-page report criticizing family detention for harms to minors’ development and well-being; advocates say those findings remain unaddressed.

Key voices:
– Setareh Ghandehari, Advocacy Director at Detention Watch Network, called the return of family detention “enraging.”
– Mishan Wroe, senior lawyer at the National Center for Youth Law, warns that with congressional funding for indefinite detention, removing court oversight would leave children exposed.

Operational realities that drive outcomes

• Control over movement, dependence on facility supplies, limited access to outside clinics, and trauma of confinement drive the medical outcomes documented in files and sworn declarations.
• In a home, a parent can boil water, restock, call a pediatrician, or visit a drugstore; in detention, everything requires permission, scheduling, and escorts.
• When a child’s head injury is not promptly assessed or a swollen foot gets only non-diagnostic advice, small problems can become serious.

Advocates’ urgent recommendations

Advocates urge three immediate steps while courts review Flores and facilities expand:
1. Ensure constant access to clean, drinkable water.
2. Guarantee timely pediatric evaluations with qualified child-health staff.
3. Restore independent monitoring, including public reporting of inspection outcomes.

Additional proposals include:
– On-call regional pediatric teams to deploy quickly to facilities reporting shortages or medical backlogs.
– Public posting of monthly inspection summaries.
– Guaranteed access for legal service providers and independent medical monitors (regardless of Flores).

What’s at stake

• If a judge rejects the government’s motion to terminate Flores, monitors would continue visits to Dilley and Karnes and report on water, clinic staffing, and sanitation.
• If the motion succeeds and legislative changes stand, families could face indefinite detention with fewer avenues for reporting problems.
• For children, the difference is tangible: measured in gallons of clean water, the timeliness and quality of a head injury exam, and access to a practitioner trained to treat pediatric needs.

Advocates stress that even if law permits broader detention, the government still has a duty and the capacity to reduce harm by:
– Applying its published standards,
– Bringing in child-health specialists,
– Ensuring independent oversight and transparent records.

Families who crossed deserts and rivers arrive in Texas not seeking comfort, but expecting safe water, food, sanitation, and medical care—standards the United States has long said it upholds. The question before courts, Congress, and the public is whether those promises will hold as family detention grows again.