Immigration and Customs Enforcement officials testifying before Congress have misrepresented the standard of medical care available to immigrants in custody, detainee advocates say.

These advocates claim that ICE failed to disclose that non-emergency conditions are assessed or treated only if doctors believe their illness would prevent deportation.

An ICE spokeswoman said Monday that no top agency officials had misrepresented ICE health care standards before Congress.

Julie L. Myers, assistant secretary of Homeland Security for ICE, testified June 4 that the agency’s health care service is focused on emergency care for the roughly 32,000 immigrants in custody.

Myers then says in her written testimony that other medical conditions “that the local treating physicians believe would cause suffering or deterioration of a detainee`s health are also assessed and evaluated through the [Department of Immigrant Health Services Managed Care Program].”

Critics say this description, which omits the deportation standard the Department of Immigrant Health Services (DIHS) imposes for treatment of chronic conditions, misconstrues the quality of health care available to immigrant detainees.

“What I find most troubling . . . is that it is the second time now that ICE has been called to testify before Congress on the issue of medical care in detention and it’s also the second time that it has misrepresented the standard,” Tom Javits, an attorney with the American Civil Liberties Union’s National Prison Project, said in an interview.

Javits said Gary E. Mead, assistant director for management of the ICE Office of Detention and Removal Operations” also diluted the non-emergency care standard in testimony Oct. 4, 2007, before the House Judiciary Immigration, Citizenship, Refugees, Border Security and International Law Subcommittee.

Mead’s written testimony includes an explanation of the standard in almost identical terms as Myers, again excluding the deportation status qualification.

DIHS’ managed care benefit package is provided to detainee medical providers for guidance on which non-emergency conditions treated in outside care facilities would be paid for by the government.

In addition to emergency services, the DIHS benefit package says that, “other medical conditions which the physician believes, if left untreated during the period of ICE/[Border Patrol] custody, would cause deterioration of the detainee’s health or uncontrolled suffering affecting his/her deportation status will be assessed and evaluated for care.”

Javits said the effect of the immigration status stipulation is that DIHS’ “mission is tied directly to deportation rather than ensuring that people receive all necessary health care.”

ICE says the critics’ interpretation takes the DIHS benefits status language out of context and that Myers and Mead did not misrepresent the health care standard before Congress.

“If a detainee has some sort of illness that is emergent and medical professionals make medical recommendations, we certainly don’t get in the way,” ICE spokeswoman Kelly Nantel said in an interview.

But Nantel’s explanation of ICE priorities comes close to confirming Javits’ assessment of those priorities.

“We are in the deportation business. . . . Obviously, our goal is to remove individuals ordered to be removed from our country,” she said. “We address their health care issues to make sure they are medically able to travel and medically able to return to their country.”

Critics, including those in the medical profession, say it is irresponsible to use removal status or other non-medical benchmarks in determining whether to assess or treat a sick detainee.

The practice “places the ICE providers in ethical jeopardy and professional society jeopardy because what it means is that these doctors and nurses are including criteria that is not in the best interest of their patients,” Homer D. Venters, a program physician with the New York University Program for Survivors of Torture, said in an interview.

And he also says it’s difficult to predict how long someone will be in detention.

“It is absolutely impossible to know because [doctors] don’t know the outcome of theses [immigration] cases, they aren’t present at the hearings, and with removals people have the right of appeal. So it is absolutely impossible for doctors and nurses to know when someone will be deported,” he said.

Nantel confirms that detainee physicians wouldn’t be able to predict how long someone could be in custody. “It’s not the physician’s area to know that,” she said.

ICE says that average detainee stay is 37 days, but some immigrants can remain in custody for years.

But Nantel also said that knowledge is irrelevant for ICE doctors treating detainees.

“They make medical decisions based on the medical conditions that the patient presents while in custody . . . the same way a doctor treats patients with conditions they present in the hospital,” she said.

Critics say the health of patients with chronic conditions — which ICE says constitute 34 percent of the detainee population — is most likely to suffer under the deportation standard.

Nantel said the vast majority of those with chronic conditions have diabetes or hypertension, and DIHS accepts 90 percent of physicians’ requests for outside health services when they are originally submitted. She added that another 9 percent are accepted after subsequent submittal.

But detainee advocates say this and other ICE statistics distort the quality of care given to detainees, arguing that ICE doctors and nurses may balk at recommending outside health services because of the DIHS standard.

“Given the pressure to deport, the money and their view that it is short term detention, there is probably a culture to put everything into this other category,” between emergencies and conditions affecting deportation, said Andrea Black, network coordinator of the Detention Watch Network.

These critics also say that the figures of detainee deaths — ICE says that 71 detainees since 2004 have died while in custody — are misleading because an unknown number of detainees die after release or deportation because of a lack of adequate treatment while in custody.

Venters, the NYU doctor, says mortality isn’t the best measure of health care quality, “because as detention becomes short and shorter, it is more likely that adverse effects are going to be found after release or deportation.”

He said morbidity, or sickness, should be the gauge of quality because it would measure chronic diseases that are out of control.

But he also says advocates have seen ICE and DIHS shifting their medical practices.

“What we’ve seen now is that when people get very, very ill, ICE moves to get them out of custody,” Venters said. . . . “Because of the publicity, they are very keen to get anybody who is ill out of their custody as soon as possible.”

Caitlin Webber can be reached at cwebber@cq.com.