Humanitarian Standards for Individuals in Customs and Border Protection Custody Act

IIB 116TH CONGRESS 1ST SESSION H. R. 3239 IN THE SENATE OF THE UNITED STATES JULY 25, 2019 Received; read twice and referred to the Committee on the Judiciary AN ACT To require U.S. Customs and Border Protection to perform an initial health screening on detainees, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 VerDate Sep 11 2014 23:34 Jul 25, 2019 Jkt 034408 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H3239.RFS H3239 Pbinns on DSK79D2C42PROD with BILLS 2 HR 3239 RFS SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 1 (a) SHORT TITLE.—This Act may be cited as the 2 ‘‘Humanitarian Standards for Individuals in Customs and 3 Border Protection Custody Act’’. 4 (b) TABLE OF CONTENTS.—The table of contents of 5 this Act is as follows: 6 Sec. 1. Short title; table of contents. Sec. 2. Initial health screening protocol. Sec. 3. Water, sanitation and hygiene. Sec. 4. Food and nutrition. Sec. 5. Shelter. Sec. 6. Coordination and Surge capacity. Sec. 7. Training. Sec. 8. Interfacility transfer of care. Sec. 9. Planning and initial implementation. Sec. 10. Contractor compliance. Sec. 11. Inspections. Sec. 12. GAO report. Sec. 13. Rules of construction. Sec. 14. Definitions. Sec. 15. Sense of Congress. SEC. 2. INITIAL HEALTH SCREENING PROTOCOL. 7 (a) IN GENERAL.—The Commissioner of U.S. Cus- 8 toms and Border Protection (referred to in this Act as 9 the ‘‘Commissioner’’), in consultation with the Secretary 10 of Health and Human Services, the Administrator of the 11 Health Resources and Services Administration, and non- 12 governmental experts in the delivery of health care in hu- 13 manitarian crises and in the delivery of health care to chil- 14 dren, shall develop guidelines and protocols for the provi- 15 sion of health screenings and appropriate medical care for 16 individuals in the custody of U.S. Customs and Border 17 VerDate Sep 11 2014 23:34 Jul 25, 2019 Jkt 034408 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H3239.RFS H3239 Pbinns on DSK79D2C42PROD with BILLS 3 HR 3239 RFS Protection (referred to in this Act as ‘‘CBP’’), as required 1 under this section. 2 (b) INITIAL SCREENING AND MEDICAL ASSESS- 3 MENT.—The Commissioner shall ensure that any indi- 4 vidual who is detained in the custody of CBP (referred 5 to in this Act as a ‘‘detainee’’) receives an initial in-person 6 screening by a licensed medical professional in accordance 7 with the standards described in subsection (c)— 8 (1) to assess and identify any illness, condition, 9 or age-appropriate mental or physical symptoms that 10 may have resulted from distressing or traumatic ex- 11 periences; 12 (2) to identify acute conditions and high-risk 13 vulnerabilities; and 14 (3) to ensure that appropriate healthcare is 15 provided to individuals as needed, including pedi- 16 atric, obstetric, and geriatric care. 17 (c) STANDARDIZATION OF INITIAL SCREENING AND 18 MEDICAL ASSESSMENT.— 19 (1) IN GENERAL.—The initial screening and 20 medical assessment shall include— 21 (A) an interview and the use of a stand- 22 ardized medical intake questionnaire or the 23 equivalent; 24 VerDate Sep 11 2014 23:34 Jul 25, 2019 Jkt 034408 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H3239.RFS H3239 Pbinns on DSK79D2C42PROD with BILLS 4 HR 3239 RFS (B) screening of vital signs, including pulse 1 rate, body temperature, blood pressure, oxygen 2 saturation, and respiration rate; 3 (C) screening for blood glucose for known 4 or suspected diabetics; 5 (D) weight assessment of detainees under 6 12 years of age; 7 (E) a physical examination; and 8 (F) a risk-assessment and the development 9 of a plan for monitoring and care, when appro- 10 priate. 11 (2) PRESCRIPTION MEDICATION.—The medical 12 professional shall review any prescribed medication 13 that is in the detainee’s possession or that was con- 14 fiscated by CBP upon arrival and determine if the 15 medication may be kept by the detainee for use dur- 16 ing detention, properly stored by CBP with appro- 17 priate access for use during detention, or maintained 18 with the detained individual’s personal property. A 19 detainee may not be denied the use of necessary and 20 appropriate medication for the management of the 21 detainee’s illness. 22 (3) RULE OF CONSTRUCTION.—Nothing in this 23 subsection shall be construed as requiring detainees 24 to disclose their medical status or history. 25 VerDate Sep 11 2014 23:34 Jul 25, 2019 Jkt 034408 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H3239.RFS H3239 Pbinns on DSK79D2C42PROD with BILLS 5 HR 3239 RFS (d) TIMING.— 1 (1) IN GENERAL.—Except as provided in para- 2 graph (2), the initial screening and medical assess- 3 ment described in subsections (b) and (c) shall take 4 place as soon as practicable, but not later than 12 5 hours after a detainee’s arrival at a CBP facility. 6 (2) HIGH PRIORITY INDIVIDUALS.—The initial 7 screening and medical assessment described in sub- 8 sections (b) and (c) shall take place as soon as prac- 9 ticable, but not later than 6 hours after a detainee’s 10 arrival at a CBP facility if the individual reasonably 11 self-identifies as having a medical condition that re- 12 quires prompt medical attention or is— 13 (A) exhibiting signs of acute or potentially 14 severe physical or mental illness, or otherwise 15 has an acute or chronic physical or mental dis- 16 ability or illness; 17 (B) pregnant; 18 (C) a child (with priority given, as appro- 19 priate, to the youngest children); or 20 (D) elderly. 21 (e) FURTHER CARE.— 22 (1) IN GENERAL.—If, as a result of the initial 23 health screening and medical assessment, the li- 24 censed medical professional conducting the screening 25 VerDate Sep 11 2014 23:34 Jul 25, 2019 Jkt 034408 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H3239.RFS H3239 Pbinns on DSK79D2C42PROD with BILLS 6 HR 3239 RFS or assessment determines that one or more of the 1 detainee’s vital sign measurements are significantly 2 outside normal ranges in accordance with the Na- 3 tional Emergency Services Education Standards, or 4 if the detainee is identified as high-risk or in need 5 of medical intervention, the detainee shall be pro- 6 vided, as expeditiously as possible, with an in-person 7 or technology-facilitated medical consultation with a 8 licensed emergency care professional. 9 (2) RE-EVALUATION.— 10 (A) IN GENERAL.—Detainees described in 11 paragraph (1) shall be re-evaluated within 24 12 hours and monitored thereafter as determined 13 by an emergency care professional (and in the 14 care of a consultation provided to a child, with 15 a licensed emergency care professional with a 16 background in pediatric care). 17 (B) REEVALUATION PRIOR TO TRANSPOR- 18 TATION.—In addition to the re-evaluations 19 under subparagraph (A), detainees shall have 20 all vital signs re-evaluated and be cleared as 21 safe to travel by a medical professional prior to 22 transportation. 23 (3) PYSCHOLOGICAL AND MENTAL CARE.—The 24 Commissioner shall ensure that detainees who have 25 VerDate Sep 11 2014 23:34 Jul 25, 2019 Jkt 034408 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H3239.RFS H3239 Pbinns on DSK79D2C42PROD with BILLS 7 HR 3239 RFS experienced physical or sexual violence or who have 1 experienced events that may cause severe trauma or 2 toxic stress, are provided access to basic, humane, 3 and supportive psychological assistance. 4 (f) INTERPRETERS.—To ensure that health 5 screenings and medical care required under this section 6 are carried out in the best interests of the detainee, the 7 Commissioner shall ensure that language-appropriate in- 8 terpretation services, including indigenous languages, are 9 provided to each detainee and that each detainee is in- 10 formed of the availability of interpretation services. 11 (g) CHAPERONES.—To ensure that health screenings 12 and medical care required under this section are carried 13 out in the best interests of the detainee— 14 (1) the Commissioner shall establish guidelines 15 for and ensure the presence of chaperones for all de- 16 tainees during medical screenings and examinations 17 consistent with relevant guidelines in the American 18 Medical Association Code of Medical Ethics, and 19 recommendations of the American Academy of Pedi- 20 atrics; and 21 (2) to the extent practicable, the physical exam- 22 ination of a child shall always be performed in the 23 presence of a parent or legal guardian or in the 24 VerDate Sep 11 2014 23:34 Jul 25, 2019 Jkt 034408 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H3239.RFS H3239 Pbinns on DSK79D2C42PROD with BILLS 8 HR 3239 RFS presence of the detainee’s closest present adult rel- 1 ative if a parent or legal guardian is unavailable. 2 (h) DOCUMENTATION.—The Commissioner shall en- 3 sure that the health screenings and medical care required 4 under this section, along with any other medical evalua- 5 tions and interventions for detainees, are documented in 6 accordance with commonly accepted standards in the 7 United States for medical record documentation. Such 8 documentation shall be provided to any individual who re- 9 ceived a health screening and subsequent medical treat- 10 ment upon release from CBP custody. 11 (i) INFRASTRUCTURE AND EQUIPMENT.—The Com- 12 missioner or the Administrator of General Services shall 13 ensure that each location to which detainees are first 14 transported after an initial encounter with an agent or of- 15 ficer of CBP has the following: 16 (1) A private space that provides a comfortable 17 and considerate atmosphere for the patient and that 18 ensures the patient’s dignity and right to privacy 19 during the health screening and medical assessment 20 and any necessary follow-up care. 21 (2) All necessary and appropriate medical 22 equipment and facilities to conduct the health 23 screenings and follow-up care required under this 24 section, to treat trauma, to provide emergency care, 25 VerDate Sep 11 2014 23:34 Jul 25, 2019 Jkt 034408 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H3239.RFS H3239 Pbinns on DSK79D2C42PROD with BILLS 9 HR 3239 RFS including resuscitation of individuals of all ages, and 1 to prevent the spread of communicable diseases. 2 (3) Basic over-the-counter medications appro- 3 priate for all age groups. 4 (4) Appropriate transportation to medical facili- 5 ties in the case of a medical emergency, or an on- 6 call service with the ability to arrive at the CBP fa- 7 cility within 30 minutes. 8 (j) PERSONNEL.—The Commissioner or the Adminis- 9 trator of General Services shall ensure that each location 10 to which detainees are first transported after an initial en- 11 counter has onsite at least one licensed medical profes- 12 sional to conduct health screenings. Other personnel that 13 are or may be necessary for carrying out the functions 14 described in subsection (e), such as licensed emergency 15 care professionals, specialty physicians (including physi- 16 cians specializing in pediatrics, family medicine, obstetrics 17 and gynecology, geriatric medicine, internal medicine, and 18 infectious diseases), nurse practitioners, other nurses, 19 physician assistants. licensed social workers, mental health 20 professionals, public health professionals, dieticians, inter- 21 preters, and chaperones, shall be located on site to the 22 extent practicable, or if not practicable, shall be available 23 on call. 24 VerDate Sep 11 2014 23:34 Jul 25, 2019 Jkt 034408 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H3239.RFS H3239 Pbinns on DSK79D2C42PROD with BILLS 10 HR 3239 RFS (k) ETHICAL GUIDELINES.—The Commissioner shall 1 ensure that all medical assessments and procedures con- 2 ducted pursuant to this section are conducted in accord- 3 ance with ethical guidelines in the applicable medical field, 4 and respect human dignity. 5 SEC. 3. WATER, SANITATION AND HYGIENE. 6 The Commissioner shall ensure that detainees have 7 access to— 8 (1) not less than 1 gallon of drinking water per 9 person per day, and age-appropriate fluids as need- 10 ed; 11 (2) a private, safe, clean, and reliable perma- 12 nent or portable toilet with proper waste disposal 13 and a hand washing station, with not less than 1 14 toilet available for every 12 male detainees, and 1 15 toilet for every 8 female detainees; 16 (3) a clean diaper changing facility, which in- 17 cludes proper waste disposal, a hand washing sta- 18 tion, and unrestricted access to diapers; 19 (4) the opportunity to bathe daily in a perma- 20 nent or portable shower that is private and secure; 21 and 22 (5) products for individuals of all age groups 23 and with disabilities to maintain basic personal hy- 24 giene, including soap, a toothbrush, toothpaste, 25 VerDate Sep 11 2014 23:34 Jul 25, 2019 Jkt 034408 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H3239.RFS H3239 Pbinns on DSK79D2C42PROD with BILLS 11 HR 3239 RFS adult diapers, and feminine hygiene products, as well 1 as receptacles for the proper storage and disposal of 2 such products. 3 SEC. 4. FOOD AND NUTRITION. 4 The Commissioner shall ensure that detainees have 5 access to— 6 (1) three meals per day including— 7 (A) in the case of an individual age 12 or 8 older, a diet that contains not less than 2,000 9 calories per day; and 10 (B) in the case of a child who is under the 11 age of 12, a diet that contains an appropriate 12 number of calories per day based on the child’s 13 age and weight; 14 (2) accommodations for any dietary needs or 15 restrictions; and 16 (3) access to food in a manner that follows ap- 17 plicable food safety standards. 18 SEC. 5. SHELTER. 19 The Commissioner shall ensure that each facility at 20 which a detainee is detained meets the following require- 21 ments: 22 (1) Except as provided in paragraph (2), males 23 and females shall be detained separately. 24 VerDate Sep 11 2014 23:34 Jul 25, 2019 Jkt 034408 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H3239.RFS H3239 Pbinns on DSK79D2C42PROD with BILLS 12 HR 3239 RFS (2) In the case of a minor child arriving in the 1 United States with an adult relative or legal guard- 2 ian, such child shall be detained with such relative 3 or legal guardian unless such an arrangement poses 4 safety or security concerns. In no case shall a minor 5 who is detained apart from an adult relative or legal 6 guardian as a result of such safety or security con- 7 cerns be detained with other adults. 8 (3) In the case of an unaccompanied minor ar- 9 riving in the United States without an adult relative 10 or legal guardian, such child shall be detained in an 11 age-appropriate facility and shall not be detained 12 with adults. 13 (4) A detainee with a temporary or permanent 14 disability shall be held in an accessible [Text truncated for display. Full text available on Congress.gov.]