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This article examines how immigrant-serving community-based organizations become implicated in state monitoring systems as they partner with public health programs. Drawing on ethnographic research and interviews with medical professionals, frontline workers, and administrators in a city in Upstate New York, I analyze how data requirements tied to state health programs incorporate immigrant-serving organizations into systems of oversight. Using the concept of system embeddedness, I show that (1) the financial precarity of immigrant-serving organizations, combined with their trusted relationships with immigrant communities, makes them indispensable actors in state-led health programs and gives rise to datafication practices; (2) data functions as a form of currency, as organizations receive funding in exchange for collecting multilayered information about immigrants; and (3) these data are entered into interoperable infrastructures that circulate information across agencies, increasing immigrants’ legibility and monitoring. The article demonstrates how CBOs become key sites where care and oversight are co-produced, and it foregrounds the ethical stakes of expanding data infrastructures in immigrant healthcare contexts amid intensified immigration enforcement. The findings point to the need for alternative data governance models that protect community trust while limiting the incorporation of care sites into expansive surveillance regimes.