One day after releasing our report on how a health professional’s dual loyalty can negatively impact the provision of health care in immigration detention, we secured a meeting with Department of Homeland Security (DHS) to discuss our findings and recommendations. Eight representatives of DHS joined the 1.5-hour briefing held at DHS headquarters in DC. While there remain some issues of disagreement as to how we can best care for this huge detained population, DHS unequivocally affirmed its commitment to continue working with PHR and other NGOs to improve access to health services in immigration detention centers across the country.To its credit, DHS has undertaken a number of measures over the past few years aimed at improving the quality and availability of health services to immigrants in detention. In particular, DHS pointed to its overhaul of the covered services package (which had previously resulted in denial of necessary medical care to many detainees) as one area where it has made improvements that will save lives. We agree that this change was critically important, and we applaud DHS’ willingness to work with us, as well as their commitment to full implementation of revised clinical guidelines and treatment authorization systems. Although many areas of policy-making in DC have become increasingly polarized in recent years, the DHS staff engaged in immigration detention reform have remained unfailingly accessible and open to dialogue with NGOs. Given their receptiveness to listen and discuss our recommendations on an ongoing basis, we are confident that we can continue to work with them to implement much-needed reform to the immigration detention system.