Staff members at immigration detention centers in California delayed medical appointments for patients complaining of shortness of breath. They inadequately supervised suicidal youths. And in one case, they failed to refer a patient with dangerously low blood pressure to a physician.

These and other health and safety problems were detailed in two reports released Tuesday. The reports, produced by state Attorney General Xavier Becerra and California State Auditor Elaine Howle, found that the inadequate medical care, along with other health and safety risks, posed a serious danger to immigration detainees.

Becerra and Howle blamed the federal and local governments for failing to oversee the detention centers, allowing the health and safety violations to persist.

“Everyone in this country has constitutional rights, and everyone at the end of the day, child and adult, deserves to be treated in a humane way,” Becerra said at a news conference in San Francisco where he announced his findings.

U.S. Immigration and Customs Enforcement is committed to “ensuring all detainees are treated in a humane and professional manner,” spokeswoman Lori Haley countered in a written statement. “The safety, rights and health of detainees in ICE’s care are of paramount concern and all ICE detention facilities are subject to stringent, regular inspections.”

Haley’s statement didn’t discuss the specific findings in the reports.

Becerra described his report as an initial look at conditions in the 10 California centers that housed immigration detainees in 2017, when his review began. The centers, overseen by ICE, hold people awaiting immigration hearings or deportation.

The federal centers have come under increased scrutiny as President Donald Trump has stepped up immigration enforcement, with reports of deaths, abuse and substandard medical care.

The reports landed on the same day as a congressional hearing on the detention of immigrants and family separation. During the hearing, Democrats questioned White House officials about the policy of taking children from their parents at the Mexican border.

Over the past three years, nearly 75,000 immigrant detainees were housed in the 10 California facilities. The immigrants, who stayed an average of more than 50 days, were held in civil, not criminal, detention.

The federal Office of Inspector General also examined detention facilities and revealed health and safety problems such as nooses in cells and “improper and overly restrictive segregation.” The inspector general also found that the federal immigration agency’s own inspections are not consistent or thorough.

“The standards are so low for these detention centers, and they are not regulated the way that they should be,” said Angelica Salas, executive director of the Coalition for Humane Immigrant Rights.

In addition to one-day visits to all of the facilities, Becerra’s Department of Justice conducted more comprehensive investigations of three: the Yolo County Juvenile Detention Facility, Theo Lacey Facility in Orange County and the West County Detention Facility in Contra Costa County. Contra Costa County decided last year no longer to house immigrant detainees in the West County facility.

The department found a number of health and safety problems in the centers:

• Staff at the Yolo facility did not adequately address the mental health needs of detainees and overused psychotropic medications. One youth had been cutting himself but wasn’t put under a special watch.
• Providers conducted superficial medical examinations that failed to rule out serious injuries or health conditions, including one case in which a detainee complained of testicular pain.
• A shortage of bilingual medical staff compromised the confidentiality of medical care and made it more difficult to access care.
• Unqualified personnel, including detention officers, deputies and licensed vocational nurses, made medical decisions.
• Dental services were often delayed, including one case in which a detainee needed urgent care for a probable “tooth eruption.” Other detainees were denied fillings and root canal procedures.

Noheli Sandoval, 32, entered the U.S. in March from Venezuela seeking asylum, and spent four months at the West County Detention Facility in Richmond.

It wasn’t easy accessing medical services there, said Sandoval, who lives in Berkeley. “You have to be practically dying for them to treat you.”

To get dental care, you had to be in pain, and the waiting list for mental health help was months long, she added.

Becerra said the federal government is not ensuring its own standards are met. And while some of the facilities already have made changes, he said he will continue monitoring them to ensure they adequately address their shortcomings. He didn’t rule out legal action.

“Our work is not done,” Becerra said. “We are prepared to do whatever we must to make sure that the laws of this country and this state … are not only protected but enforced.”

A separate but equally damning report by the state auditor concluded that California cities that contract with ICE to house immigration detainees are not providing adequate oversight, putting the detainees’ health and safety at risk.

The report highlights health care at three detention centers: Adelanto Detention Facility in Adelanto, Mesa Verde Detention Facility in McFarland and Imperial Regional Detention Facility in Holtville.

Those cities subcontract with private businesses to manage and operate the detention facilities, but they provided “little or no oversight of the private operators and simply passed federal payments from ICE to these subcontractors,” Howle wrote in a letter to the legislature.

Most of the health concerns raised in her report occurred during an unannounced federal inspection in May at the Adelanto Detention Facility, where inspectors found that detainees had hung bedsheets, which could be used to attempt suicide. In 2017, a detainee died after staff found him hanging from his sheets. The report said there had been three other suicide attempts by hanging as well.

The inspection also revealed that medical providers at the Adelanto facility did not conduct face-to-face medical assessments of detainees in segregation, but instead performed “cursory walk-throughs.” Nor did the facility provide proper interpretation services for people seeking care, or adequate dental services. No detainees had received fillings in the last four years, the report said.

“The city takes the findings contained in the report seriously and appreciates the recommendations,” said Adelanto city spokeswoman Michelle Van Der Linden in an emailed statement. The city, she added, is in the process of forming a committee to oversee the operation of the facility.

The city of McFarland recently announced it will not renew its contract with ICE.

During the five-year period covered by the auditor, the cities did not review complaints or inspection reports, the report said.

These cities have done little “to ensure that they are living up to their responsibilities in ensuring the safety and well-being of the detainees there,” said Michael Kaufman, senior staff attorney of the ACLU of Southern California.