Combating Trafficking of Cuban Doctors Act of 2020

II 116TH CONGRESS 2D SESSION S. 4635 To respond to international trafficking of Cuban medical professionals by the Government of Cuba, and for other purposes. IN THE SENATE OF THE UNITED STATES SEPTEMBER 21, 2020 Mr. MENENDEZ (for himself and Mr. RUBIO) introduced the following bill; which was read twice and referred to the Committee on the Judiciary A BILL To respond to international trafficking of Cuban medical professionals by the Government of Cuba, 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 ‘‘Combating Trafficking of Cuban Doctors Act of 2020’’. 5 (b) TABLE OF CONTENTS.—The table of contents for 6 this Act is as follows: 7 Sec. 1. Short title; table of contents. Sec. 2. Findings. Sec. 3. Sense of Congress. Sec. 4. Annual report and determination on international trafficking of Cuban medical personnel. VerDate Sep 11 2014 19:32 Oct 05, 2020 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6211 E:\BILLS\S4635.IS S4635 pamtmann on DSKBC07HB2PROD with BILLS 2 •S 4635 IS Sec. 5. Reestablishing the Cuban Medical Professionals Parole program. Sec. 6. Role of the Pan American Health Organization. SEC. 2. FINDINGS. 1 Congress makes the following findings: 2 (1) In 2019, the Government of Cuba main- 3 tained an estimated 34,000 to 50,000 medical per- 4 sonnel in more than 60 countries under conditions 5 that represent forced labor, according to the Depart- 6 ment of State. 7 (2) Since the outbreak of the COVID–19 pan- 8 demic in early 2020, the Government of Cuba has 9 deployed approximately 1,500 medical personnel to 10 at least 20 countries. 11 (3) The Department of State’s 2020 Traf- 12 ficking in Persons report ranked Cuba in Tier 3 and 13 included evidence regarding Cuba’s foreign medical 14 missions and the Government of Cuba’s long- 15 standing failure to criminalize most forms of forced 16 labor, specifically noting allegations that Cuban au- 17 thorities coerced participants to remain in foreign 18 medical missions by— 19 (A) ‘‘withholding their passports and med- 20 ical credentials’’; 21 (B) ‘‘using ‘minders’ to conduct surveil- 22 lance of participants outside of work’’; 23 (C) ‘‘restricting their movement’’; 24 VerDate Sep 11 2014 03:20 Oct 07, 2020 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S4635.IS S4635 pamtmann on DSKBC07HB2PROD with BILLS 3 •S 4635 IS (D) ‘‘retaliat[ing] against their family 1 members in Cuba if participants leave the pro- 2 gram’’; or 3 (E) ‘‘impos[ing] criminal penalties, exile, 4 and family separation if participants do not re- 5 turn to Cuba as directed by government super- 6 visors’’. 7 (4) On July 26, 2019, the United States im- 8 posed visa restrictions under section 212(a)(3)(C) of 9 the Immigration and Nationality Act (8 U.S.C. 10 1182(a)(3)(C)) against certain Cuban officials and 11 other individuals responsible for the coercive labor 12 practices of Cuba’s overseas medical missions. 13 (5) The United Nations Special Rapporteur on 14 contemporary forms of slavery and the United Na- 15 tions Special Rapporteur on trafficking in persons, 16 especially women and children, in their letter to the 17 Government of Cuba on November 6, 2019— 18 (A) noted reports of coercive labor prac- 19 tices through the Government of Cuba’s foreign 20 medical missions; 21 (B) highlighted reports by Cuban medical 22 professionals that they received regular threats 23 from Cuban officials while working overseas, in- 24 cluding sexual harassment of women; and 25 VerDate Sep 11 2014 19:32 Oct 05, 2020 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S4635.IS S4635 pamtmann on DSKBC07HB2PROD with BILLS 4 •S 4635 IS (C) expressed concern that the practices 1 referred to in subparagraphs (A) and (B) con- 2 stitute slavery and trafficking in persons. 3 (6) In July 2013, the Cuban Ministry of Health 4 signed an agreement with the Brazilian Ministry of 5 Health to formalize an arrangement for Cuban doc- 6 tors to provide medical services in Brazil that— 7 (A) required the administration of former 8 Brazilian President Dilma Rousseff to transmit 9 a monthly payment through the Pan American 10 Health Organization (referred to in this section 11 as ‘‘PAHO’’) to the Cuban Ministry of Health 12 for the medical services provided by each Cuban 13 doctor serving in Brazil; and 14 (B) prevented participating Cuban doctors 15 from seeking employment in Brazil outside of 16 the formal structure of the agreement. 17 (7) In implementing the agreement described in 18 paragraph (6), the Cuban Ministry of Health acted 19 through the for-profit Cuban Medical Services Trad- 20 ing Corporation (referred to in this section as 21 ‘‘CMS’’)— 22 (A) to pay each Cuban doctor approxi- 23 mately 25 percent (averaging $790) of the 24 VerDate Sep 11 2014 19:32 Oct 05, 2020 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S4635.IS S4635 pamtmann on DSKBC07HB2PROD with BILLS 5 •S 4635 IS monthly payment received from PAHO (aver- 1 aging $3,158); and 2 (B) to retain approximately 75 percent of 3 the monthly payment for each doctor received 4 from PAHO. 5 (8) Between 2013 and 2019, according to the 6 digital platform Diario de Cuba, the Government of 7 Cuba— 8 (A) garnished the salaries of more than 9 20,000 Cuban medical professionals who served 10 in Brazil under the Mais Me´dicos program; 11 (B) frequently confiscated their passports; 12 and 13 (C) prohibited family members from ac- 14 companying them. 15 (9) Cuban doctors were the only medical profes- 16 sionals participating in the Mais Me´dicos program to 17 have their salaries directly garnished by their gov- 18 ernment, while doctors of other nationalities serving 19 in Brazil received the full amount of the payments 20 made for their medical services under the program. 21 (10) The Government of Cuba stated that 22 Cuban doctors unwilling to return to the country 23 after their participation in foreign medical missions 24 VerDate Sep 11 2014 19:32 Oct 05, 2020 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S4635.IS S4635 pamtmann on DSKBC07HB2PROD with BILLS 6 •S 4635 IS would not be permitted to return to their homeland 1 for 8 years. 2 (11) In February 2019, Brazil’s Ministry of 3 Health announced the termination of the Mais 4 Me´dicos program. 5 (12) The Government of Cuba realized profits 6 in excess of $6,300,000,000 during 2018 from ex- 7 porting the services of Cuban professionals, of which 8 foreign medical missions represent the majority of 9 the services and income. 10 (13) Countries in which similar abuses to those 11 suffered by Cuban medical professionals in Brazil 12 have been reported to have occurred include Angola, 13 Guatemala, Mexico, Qatar, and Venezuela. 14 (14) In Venezuela, a group of Cuban doctors 15 reported in 2019 that they had been directed, and 16 often coerced, to use their medical services to influ- 17 ence votes in favor of the Maduro regime, includ- 18 ing— 19 (A) by denying medical treatment to oppo- 20 sition supporters; and 21 (B) by giving precise voting instructions to 22 elderly patients. 23 (15) The term ‘‘severe forms of trafficking in 24 persons’’ is defined under section 103(11)(B) of the 25 VerDate Sep 11 2014 19:32 Oct 05, 2020 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S4635.IS S4635 pamtmann on DSKBC07HB2PROD with BILLS 7 •S 4635 IS Trafficking Victims Protection Act of 2000 (22 1 U.S.C. 7102(11)(B)) as ‘‘the recruitment, harboring, 2 transportation, provision, or obtaining of a person 3 for labor or services, through the use of force, fraud, 4 or coercion for the purpose of subjection to involun- 5 tary servitude, peonage, debt bondage, or slavery’’. 6 SEC. 3. SENSE OF CONGRESS. 7 It is the sense of Congress that— 8 (1) the Government of Cuba subjects Cuban 9 doctors and other medical professionals to state- 10 sponsored human trafficking; 11 (2) the Government of Cuba should fully com- 12 pensate Cuban medical professionals who have par- 13 ticipated in, or who are currently participating in 14 foreign medical mission programs in other countries, 15 including Brazil’s Mais Me´dicos program, for the 16 full amount of wages paid to the Government of 17 Cuba; 18 (3) the Government of Cuba should immediately 19 and transparently respond to requests for informa- 20 tion from the United Nations Special Rapporteur on 21 contemporary forms of slavery and the United Na- 22 tions Special Rapporteur on trafficking in persons, 23 especially women and children; and 24 VerDate Sep 11 2014 03:20 Oct 07, 2020 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S4635.IS S4635 pamtmann on DSKBC07HB2PROD with BILLS 8 •S 4635 IS (4) foreign governments that sign agreements 1 with the Government of Cuba or the for-profit 2 Cuban Medical Services Trading Corporation or 3 other companies affiliated with the Government of 4 Cuba to procure the services of Cuban medical pro- 5 fessionals directly assume legal risks related to their 6 participation in forced labor arrangements. 7 SEC. 4. ANNUAL REPORT AND DETERMINATION ON INTER- 8 NATIONAL TRAFFICKING OF CUBAN MEDICAL 9 PERSONNEL. 10 (a) ANNUAL REPORT.—Not later than 180 days after 11 the date of the enactment of this Act and annually there- 12 after until the date specified in subsection (c), the Sec- 13 retary of State shall submit a report to the Committee 14 on Foreign Relations of the Senate and the Committee 15 on Foreign Affairs of the House of Representatives that— 16 (1) identifies the countries that are hosting 17 Cuban medical personnel who are participating in 18 foreign medical missions for the Government of 19 Cuba; 20 (2) to the extent feasible, includes an estimate 21 of— 22 (A) the number of Cuban medical per- 23 sonnel in each country; and 24 VerDate Sep 11 2014 19:32 Oct 05, 2020 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S4635.IS S4635 pamtmann on DSKBC07HB2PROD with BILLS 9 •S 4635 IS (B) the value of the financial arrangement 1 between the Government of Cuba and the host 2 country government; and 3 (3) describes the conditions in each country 4 under which Cuban medical personnel live and work. 5 (b) DETERMINATION ON HUMAN TRAFFICKING.—In 6 each report submitted pursuant to subsection (a), the Sec- 7 retary of State shall determine whether— 8 (1) the Cuban medical personnel in each coun- 9 try identified in the report are subjected to condi- 10 tions that qualify as severe forms of trafficking in 11 persons (as defined in section 103(11) of the Traf- 12 ficking Victims Protection Act of 2000 (22 U.S.C. 13 7102(11))); and 14 (2) Cuba’s foreign medical missions program 15 constitutes proof of failure to make significant ef- 16 forts to bring the Government of Cuba into compli- 17 ance with the minimum standards for the elimi- 18 nation of trafficking in persons (as determined 19 under section 108 of the Trafficking Victims Protec- 20 tion Act of 2000 (22 U.S.C. 7106)). 21 (c) SUNSET.—The Secretary of State is not required 22 to submit the report otherwise required under subsection 23 (a) after the date on which the Secretary submits a second 24 consecutive annual report under such subsection that in- 25 VerDate Sep 11 2014 19:32 Oct 05, 2020 Jkt 019200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S4635.IS S4635 pamtmann on DSKBC07HB2PROD with BILLS 10 •S 4635 IS cludes a determination under subsection (b) that Cuban 1 medical personnel are no longer subjected to trafficking 2 in persons. 3 SEC. 5. REESTABLISHING THE CUBAN MEDICAL PROFES- 4 SIONAL PAROLE PROGRAM. 5 (a) IN GENERAL.—The Secretary of Homeland Secu- 6 rity, in coordination with the Secretary of State, shall rein- 7 state the Cuban Medical Professional Parole program to 8 authorize the admission into the United States of Cuban 9 medical personnel conscripted to study or work in a third 10 country under the direction of the Government of Cuba. 11 (b) AUTHORITY.—The Director of U.S. Citizenship 12 and Immigration Services may exercise its discretionary 13 parole authority under section 212(d)(5)(A) of the Immi- 14 gration and Nationality Act (8 U.S.C. 1182(d)(5)(A)) and 15 subsections (c) and (d) of section 212.5 of title 8, Code 16 of Federal Regulations, to permit eligible Cuban nationals 17 to come to the United States, including for urgent human- 18 itarian reasons or significant public benefit. 19 (c) ELIGIBILITY CRITERIA.— 20 (1) IN GENERAL.—A Cuban medical profes- 21 sional is eligible for consideration of parole under 22 the Cuban Medical Professional Program if he or 23 she— 24 VerDate Sep 11 2014 03:20 Oct 07, 2020 Jkt 019200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S4635.IS S4635 pamtmann on DSKBC07HB2PROD with BILLS 11 •S 4635 IS (A) is a Cuban national, citizen, or person 1 habitually residing in Cuba; 2 (B) is a medical professional who, at the 3 time he or she seeks such parole, is conscripted 4 by the Government of Cuba to study or work in 5 a third country; and 6 (C) is not inadmissible under section 7 212(a) of the Immigration and Nationality Act 8 (8 U.S.C. 1182(a)). 9 (2) ADMISSION OF FAMILY MEMBERS.— 10 (A) IN GENERAL.—The spouse and unmar- 11 ried children accompanying the primary appli- 12 cant in the third country referred to in para- 13 graph (1)(B) shall be eligible for parole under 14 the Cuban Medical Professional Program in 15 conjunction with an application from an indi- 16 vidual described in paragraph (1). 17 (B) APPLICATIONS.—A Cuban medical 18 professional granted discretionary parole under 19 section 212(d)(5)(A) of the Immigration and 20 Nationality Act (8 U.S.C. 1182(d)(5)(A)) pur- 21 suant to this section may submit an application 22 to U.S. Citizenship and Immigration Services 23 seeking admission to the United States of his or 24 her spouse and unmarried children. 25 VerDate Sep 11 2014 19:32 Oct 05, 2020 Jkt 019200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S4635.IS S4635 pamtmann on DSKBC07HB2PROD with BILLS 12 •S 4635 IS SEC. 6. ROLE OF THE PAN AMERICAN HEALTH ORGANIZA- 1 TION. 2 (a) FINDINGS.—Congress finds that the Pan Amer- 3 ican Health Organization (referred to in this section as 4 ‘‘PAHO’’)— 5 (1) has contributed to the health and well-being 6 of the people in the Western Hemisphere for longer 7 than a century, with the United States serving as a 8 member state since 1925; 9 (2) engages in technical cooperation with its 10 member countries— 11 (A) to fight communicable and noncommu- 12 nicable diseases and their causes; 13 (B) to strengthen health systems; and 14 (C) to respond to emergencies and disas- 15 ters; 16 (3) as of August 24, 2020, had assisted dozens [Text truncated for display. Full text available on Congress.gov.]