Humanitarian Standards for Individuals in Customs and Border Protection Custody Act

II 116TH CONGRESS 1ST SESSION S. 2135 To require U.S. Customs and Border Protection to perform an initial health screening on detainees, and for other purposes. IN THE SENATE OF THE UNITED STATES JULY 17, 2019 Mr. UDALL (for himself, Mr. BROWN, and Mr. HEINRICH) introduced the fol- lowing bill; which was read twice and referred to the Committee on the Judiciary A BILL 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 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 3 (a) SHORT TITLE.—This Act may be cited as the 4 ‘‘Humanitarian Standards for Individuals in Customs and 5 Border Protection Custody Act’’. 6 (b) TABLE OF CONTENTS.—The table of contents for 7 this Act is as follows: 8 Sec. 1. Short title; table of contents. Sec. 2. Definitions. VerDate Sep 11 2014 02:04 Jul 20, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6211 E:\BILLS\S2135.IS S2135 kjohnson on DSK79L0C42 with BILLS 2 •S 2135 IS Sec. 3. Initial health screening protocol. Sec. 4. Water, sanitation, and hygiene. Sec. 5. Food and nutrition. Sec. 6. Shelter. Sec. 7. Coordination and surge capacity. Sec. 8. Training. Sec. 9. Interfacility transfer of care. Sec. 10. Planning and initial implementation. Sec. 11. Contractor compliance. Sec. 12. Inspections. Sec. 13. GAO report. Sec. 14. Rule of construction. SEC. 2. DEFINITIONS. 1 In this Act: 2 (1) INTERPRETATION SERVICES.—The term 3 ‘‘interpretation services’’ includes translation serv- 4 ices that are performed either in-person or through 5 a telephone or video service. 6 (2) CHILD.—The term ‘‘child’’ has the meaning 7 given the term in section 101(b)(1) of the Immigra- 8 tion and Nationality Act (8 U.S.C. 1101(b)(1)). 9 (3) U.S. CUSTOMS AND BORDER PROTECTION 10 FACILITY.—The term ‘‘U.S. Customs and Border 11 Protection Facility’’ includes— 12 (A) U.S. Border Patrol stations; 13 (B) ports of entry; 14 (C) checkpoints; 15 (D) forward operating bases; 16 (E) secondary inspection areas; and 17 (F) short-term custody facilities. 18 (4) FORWARD OPERATING BASE.—The term 19 ‘‘forward operating base’’ means a permanent facil- 20 VerDate Sep 11 2014 23:54 Jul 22, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S2135.IS S2135 kjohnson on DSK79L0C42 with BILLS 3 •S 2135 IS ity established by CBP in forward or remote loca- 1 tions, and designated as such by CBP. 2 SEC. 3. INITIAL HEALTH SCREENING PROTOCOL. 3 (a) IN GENERAL.—The Commissioner of U.S. Cus- 4 toms and Border Protection (referred to in this Act as 5 the ‘‘Commissioner’’), in consultation with the Secretary 6 of Health and Human Services, the Administrator of the 7 Health Resources and Services Administration, and non- 8 governmental experts in the delivery of health care in hu- 9 manitarian crises and in the delivery of health care to chil- 10 dren, shall develop guidelines and protocols for the provi- 11 sion of health screenings and appropriate medical care for 12 individuals in the custody of U.S. Customs and Border 13 Protection (referred to in this Act as ‘‘CBP’’), as required 14 under this section. 15 (b) INITIAL SCREENING AND MEDICAL ASSESS- 16 MENT.—The Commissioner shall ensure that any indi- 17 vidual who is detained in the custody of CBP (referred 18 to in this Act as a ‘‘detainee’’) receives an initial in-person 19 screening by a licensed medical professional in accordance 20 with the standards described in subsection (c)— 21 (1) to assess and identify any illness, condition, 22 or age-appropriate mental or physical symptoms that 23 may have resulted from distressing or traumatic ex- 24 periences; 25 VerDate Sep 11 2014 02:04 Jul 20, 2019 Jkt 089200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S2135.IS S2135 kjohnson on DSK79L0C42 with BILLS 4 •S 2135 IS (2) to identify acute conditions and high-risk 1 vulnerabilities; and 2 (3) to ensure that appropriate healthcare is 3 provided to individuals as needed, including pedi- 4 atric, obstetric, and geriatric care. 5 (c) STANDARDIZATION OF INITIAL SCREENING AND 6 MEDICAL ASSESSMENT.— 7 (1) IN GENERAL.—The initial screening and 8 medical assessment required under subsection (b) 9 shall include— 10 (A) an interview and the use of a stand- 11 ardized medical intake questionnaire or the 12 equivalent; 13 (B) screening of vital signs, including pulse 14 rate, body temperature, blood pressure, oxygen 15 saturation, and respiration rate; 16 (C) screening for blood glucose for known 17 or suspected diabetics; 18 (D) weight assessment of detainees who 19 are younger than 12 years of age; 20 (E) a physical examination; and 21 (F) a risk assessment and the development 22 of a plan for monitoring and care, as appro- 23 priate. 24 VerDate Sep 11 2014 23:54 Jul 22, 2019 Jkt 089200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S2135.IS S2135 kjohnson on DSK79L0C42 with BILLS 5 •S 2135 IS (2) PRESCRIPTION MEDICATION.—The medical 1 professional conducting the initial screening and 2 medical assessment shall review any prescribed 3 medication that is in the detainee’s possession or 4 that was confiscated by CBP upon arrival and deter- 5 mine if the medication may be kept by the detainee 6 for use during detention, properly stored by CBP 7 with appropriate access for use during detention, or 8 maintained with the detained individual’s personal 9 property. A detainee may not be denied the use of 10 necessary and appropriate medication for the man- 11 agement of the detainee’s chronic illness. 12 (3) RULE OF CONSTRUCTION.—Nothing in this 13 subsection may be construed as requiring detainees 14 to disclose their medical status or history. 15 (d) TIMING.— 16 (1) IN GENERAL.—Except as provided in para- 17 graph (2), the initial screening and medical assess- 18 ment required under this section shall take place as 19 soon as practicable, but not later than 12 hours 20 after a detainee’s arrival at a CBP facility. 21 (2) HIGH-PRIORITY INDIVIDUALS.—The initial 22 screening and medical assessment required under 23 this section shall take place as soon as practicable, 24 but not later than 6 hours after a detainee’s arrival 25 VerDate Sep 11 2014 23:54 Jul 22, 2019 Jkt 089200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S2135.IS S2135 kjohnson on DSK79L0C42 with BILLS 6 •S 2135 IS at a CBP facility if the individual reasonably self- 1 identifies as having a medical condition that requires 2 prompt medical attention or is— 3 (A) exhibiting signs of acute or potentially 4 severe physical or mental illness, or otherwise 5 has an acute or chronic physical or mental dis- 6 ability or illness; 7 (B) pregnant; 8 (C) a child (with priority given, as appro- 9 priate, to the youngest children); or 10 (D) elderly. 11 (e) FURTHER CARE.— 12 (1) IN GENERAL.—If, as a result of the initial 13 health screening and medical assessment, the li- 14 censed medical professional conducting the screening 15 or assessment determines that 1 or more of the de- 16 tainee’s vital sign measurements are outside normal 17 ranges in accordance with the National Emergency 18 Services Education Standards, or if the detainee is 19 identified as high-risk or in need of medical inter- 20 vention, the detainee shall be provided, as expedi- 21 tiously as possible, with an in-person or technology- 22 facilitated medical consultation with a licensed emer- 23 gency care professional. 24 (2) RE-EVALUATION.— 25 VerDate Sep 11 2014 02:04 Jul 20, 2019 Jkt 089200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S2135.IS S2135 kjohnson on DSK79L0C42 with BILLS 7 •S 2135 IS (A) IN GENERAL.—Detainees described in 1 paragraph (1) shall be reevaluated within 24 2 hours and monitored thereafter as determined 3 by an emergency care professional. 4 (B) REEVALUATION PRIOR TO TRANSPOR- 5 TATION.—In addition to the reevaluations 6 under subparagraph (A), detainees shall have 7 all vital signs reevaluated and be cleared as safe 8 to travel by a medical professional before being 9 transported. 10 (3) PYSCHOLOGICAL AND MENTAL CARE.—The 11 Commissioner shall ensure that detainees who have 12 experienced physical or sexual violence or who have 13 experienced events that may cause severe trauma or 14 toxic stress, are provided access to basic, humane, 15 and supportive psychological assistance. 16 (f) INTERPRETERS.—To ensure that health 17 screenings and medical care required under this section 18 are carried out in the best interests of the detainee, the 19 Commissioner shall ensure that language-appropriate in- 20 terpretation services, including indigenous languages, are 21 provided to each detainee and that each detainee is in- 22 formed of the availability of interpretation services. 23 VerDate Sep 11 2014 23:54 Jul 22, 2019 Jkt 089200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S2135.IS S2135 kjohnson on DSK79L0C42 with BILLS 8 •S 2135 IS (g) CHAPERONES.—To ensure that health screenings 1 and medical care required under this section are carried 2 out in the best interests of the detainee— 3 (1) the Commissioner shall establish guidelines 4 for and ensure the presence of chaperones for all de- 5 tainees during medical screenings and examinations 6 consistent with relevant guidelines in the American 7 Medical Association and American Association of 8 Pediatrics Code of Medical Ethics; and 9 (2) to the extent practicable, the physical exam- 10 ination of a child shall always be performed in the 11 presence of a parent or legal guardian or in the 12 presence of the detainee’s closest present adult rel- 13 ative if a parent or legal guardian is unavailable. 14 (h) DOCUMENTATION.—The Commissioner shall en- 15 sure that the health screenings and medical care required 16 under this section, along with any other medical evalua- 17 tions and interventions for detainees, are documented in 18 accordance with commonly accepted standards in the 19 United States for medical record documentation. Such 20 documentation shall be provided to any individual who re- 21 ceived a health screening and subsequent medical treat- 22 ment upon release from CBP custody. 23 (i) INFRASTRUCTURE AND EQUIPMENT.—The Com- 24 missioner or the Administrator of General Services shall 25 VerDate Sep 11 2014 02:04 Jul 20, 2019 Jkt 089200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S2135.IS S2135 kjohnson on DSK79L0C42 with BILLS 9 •S 2135 IS ensure that each location to which detainees are first 1 transported after an initial encounter with an agent or of- 2 ficer of CBP has— 3 (1) a private space that provides a comfortable 4 and considerate atmosphere for the patient and that 5 ensures the patient’s dignity and right to privacy 6 during the health screening and medical assessment 7 and any necessary follow-up care; 8 (2) all necessary and appropriate medical equip- 9 ment and facilities to conduct the health screenings 10 and follow-up care required under this section, to 11 treat trauma, to provide emergency care, including 12 resuscitation of individuals of all ages, and to pre- 13 vent the spread of communicable diseases; 14 (3) basic over-the-counter medications appro- 15 priate for all age groups; and 16 (4) appropriate transportation to medical facili- 17 ties in the case of a medical emergency, or an on- 18 call service with the ability to arrive at the CBP fa- 19 cility within 30 minutes. 20 (j) PERSONNEL.—The Commissioner or the Adminis- 21 trator of General Services shall ensure that each location 22 to which detainees are first transported after an initial en- 23 counter has onsite at least 1 licensed medical professional 24 to conduct health screenings. Other personnel that are or 25 VerDate Sep 11 2014 02:04 Jul 20, 2019 Jkt 089200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S2135.IS S2135 kjohnson on DSK79L0C42 with BILLS 10 •S 2135 IS may be necessary for carrying out the functions described 1 in this section, such as licensed emergency care profes- 2 sionals, specialty physicians (including physicians special- 3 izing in pediatrics, family medicine, obstetrics and gyne- 4 cology, geriatric medicine, internal medicine, and infec- 5 tious diseases), nurse practitioners, other nurses, physi- 6 cian assistants, licensed social workers, mental health pro- 7 fessionals, public health professionals, dieticians, inter- 8 preters, and chaperones, shall be located on site to the 9 extent practicable, or if not practicable, shall be available 10 on call. 11 (k) ETHICAL GUIDELINES.—The Commissioner shall 12 ensure that all medical assessments and procedures con- 13 ducted pursuant to this section are conducted in accord- 14 ance with ethical guidelines in the applicable medical field, 15 and respect human dignity. 16 SEC. 4. WATER, SANITATION, AND HYGIENE. 17 The Commissioner shall ensure that detainees have 18 access to— 19 (1) not less than 1 gallon of drinking water per 20 day, and age-appropriate fluids as needed; 21 (2) a private, safe, clean, and reliable perma- 22 nent or portable toilet with proper waste disposal 23 and a hand washing station, with not less than 1 24 VerDate Sep 11 2014 23:54 Jul 22, 2019 Jkt 089200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S2135.IS S2135 kjohnson on DSK79L0C42 with BILLS 11 •S 2135 IS toilet available for every 12 male detainees, and 1 1 toilet for every 8 female detainees; 2 (3) a clean diaper changing facility, which in- 3 cludes proper waste disposal, a hand washing sta- 4 tion, and unrestricted access to diapers; 5 (4) the opportunity to bathe daily in a perma- 6 nent or portable shower that is private and secure; 7 and 8 (5) products for individuals of all age groups 9 and with disabilities to maintain basic personal hy- 10 giene, including soap, a toothbrush, toothpaste, 11 adult diapers, and feminine hygiene products, as well 12 as receptacles for the proper storage and disposal of 13 such products. 14 SEC. 5. FOOD AND NUTRITION. 15 The Commissioner shall ensure that detainees have 16 access to— 17 (1) 3 meals per day including— 18 (A) in the case of an individual who is at 19 least 12 years of age, a diet that contains not 20 less than 2,000 calories per day; and 21 (B) in the case of a child who is younger 22 than 12 years of age, a diet that contains an 23 appropriate number of calories per day based 24 on the child’s age and weight; 25 VerDate Sep 11 2014 02:04 Jul 20, 2019 Jkt 089200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S2135.IS S2135 kjohnson on DSK79L0C42 with BILLS 12 •S 2135 IS (2) accommodations for any dietary needs or 1 restrictions; and 2 (3) access to food in a manner that follows ap- 3 plicable food safety standards. 4 SEC. 6. SHELTER. 5 The Commissioner shall ensure that each facility [Text truncated for display. Full text available on Congress.gov.]