[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 2864 Introduced in Senate (IS)]
<DOC>
118th CONGRESS
1st Session
S. 2864
To require U.S. Customs and Border Protection to perform an initial
health screening on all detainees, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
September 20, 2023
Mr. Lujan introduced the following 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 all detainees, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Humanitarian
Standards for Individuals in U.S. Customs and Border Protection Custody
Act''.
(b) Table of Contents.--The table of contents for this Act is as
follows:
Sec. 1. Short title; table of contents.
Sec. 2. Definitions.
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. Government Accountability Office report.
Sec. 14. Publication of data on complaints of sexual abuse at U.S.
Customs and Border Protection facilities.
Sec. 15. Rules of construction.
SEC. 2. DEFINITIONS.
In this Act:
(1) CBP.--The term ``CBP'' means U.S. Customs and Border
Protection.
(2) Child.--The term ``child'' has the meaning given such
term in section 101(b)(1) of the Immigration and Nationality
Act (8 U.S.C. 1101(b)(1)).
(3) Commissioner.--The term ``Commissioner'' means the
Commissioner of U.S. Customs and Border Protection.
(4) Detainee.--The term ``detainee'' means any individual
who is detained in CBP custody.
(5) Forward operating base.--The term ``forward operating
base'' means a permanent facility that has been established by
CBP in a forward or remote location and has been so designated
by CBP.
(6) Interpretation services.--The term ``interpretation
services'' includes translation services that are performed in
person or through a telephone or video service.
(7) U.S. customs and border protection facility.--The term
``U.S. Customs and Border Protection facility'' includes--
(A) U.S. Border Patrol stations;
(B) ports of entry;
(C) checkpoints;
(D) forward operating bases;
(E) secondary inspection areas; and
(F) short-term custody facilities.
SEC. 3. INITIAL HEALTH SCREENING PROTOCOL.
(a) In General.--The Commissioner, in consultation with the
Secretary of Health and Human Services, the Administrator of the Health
Resources and Services Administration, and nongovernmental experts in
the delivery of health care in humanitarian crises and in the delivery
of health care to children, shall develop guidelines and protocols for
the provision of health screenings and appropriate medical care for
detainees, as required under this section.
(b) Initial Screening and Medical Assessment.--The Commissioner
shall ensure that all detainees receive an initial in-person screening
by a licensed medical professional in accordance with the standards
described in subsection (c)--
(1) to assess and identify any illness, condition, or age-
appropriate mental or physical symptoms that may have resulted
from distressing or traumatic experiences;
(2) to identify acute conditions and high-risk
vulnerabilities; and
(3) to ensure that appropriate health care is provided to
individuals as needed, including pediatric, obstetric, and
geriatric care.
(c) Standardization of Initial Screening and Medical Assessment.--
(1) In general.--The initial screening and medical
assessment of detainees shall include--
(A) an interview and the use of a standardized
medical intake questionnaire or the equivalent;
(B) screening of vital signs, including pulse rate,
body temperature, blood pressure, oxygen saturation,
and respiration rate;
(C) screening for blood glucose for known or
suspected diabetics;
(D) weight assessment of detainees younger than 12
years of age;
(E) a physical examination; and
(F) a risk assessment and the development of a plan
for monitoring and care, as appropriate.
(2) Prescription medication.--
(A) In general.--The medical professional
conducting the screening pursuant to subsection (b)
shall--
(i) review any prescribed medication that
is in the detainee's possession or that was
confiscated by CBP upon arrival; and
(ii) determine if such medication should
be--
(I) kept by the detainee for use
during detention;
(II) properly stored by CBP, with
appropriate access for use during
detention; or
(III) maintained with the detained
individual's personal property.
(B) Right to medication.--A detainee may not be
denied the use of necessary and appropriate medication
for the management of the detainee's illness.
(3) Rule of construction.--Nothing in this subsection may
be construed as requiring detainees to disclose their medical
status or history.
(d) Timing.--
(1) In general.--Except as provided in paragraph (2), the
initial screening and medical assessment described in
subsections (b) and (c) shall take place as soon as
practicable, but not later than 12 hours after a detainee's
arrival at a CBP facility.
(2) High priority individuals.--The initial screening and
medical assessment referred to in paragraph (1) shall take
place as soon as practicable, but not later than 6 hours after
a detainee's arrival at a CBP facility if the individual--
(A) reasonably self-identifies as having a medical
condition that requires prompt medical attention; or
(B) is--
(i) exhibiting signs of acute or
potentially severe physical or mental illness,
or otherwise has an acute or chronic physical
or mental disability or illness;
(ii) pregnant;
(iii) a child (with priority given, as
appropriate, to the youngest children); or
(iv) elderly.
(e) Further Care.--
(1) In general.--If, as a result of the initial health
screening and medical assessment described in subsections (b)
and (c), the licensed medical professional conducting such
screening or assessment determines that 1 or more of the
detainee's vital sign measurements are significantly outside
normal ranges, in accordance with the National Emergency
Services Education Standards, or if the detainee is identified
as high risk or in need of medical intervention, the detainee
shall be provided, as expeditiously as possible, with an in-
person or technology-facilitated medical consultation with a
licensed emergency care professional.
(2) Reevaluation.--
(A) In general.--Each detainee described in
paragraph (1)--
(i) shall be reevaluated not later than 24
hours after the consultation required under
such paragraph; and
(ii)(I) shall be monitored thereafter as
determined by an emergency care professional;
or
(II) if the detainee is a child, shall be
monitored thereafter as determined by a
licensed emergency care professional with a
background in pediatric care.
(B) Reevaluation before travel.--In addition to the
reevaluations required under subparagraph (A),
detainees described in paragraph (1), before being
transported to another location--
(i) shall have all of their vital signs
reevaluated; and
(ii) shall be cleared by a medical
professional as being able to travel safely.
(3) Psychological and mental care.--The Commissioner shall
ensure that detainees who have experienced physical or sexual
violence or who have experienced events that may cause severe
trauma or toxic stress, are provided access to basic, humane,
and supportive psychological assistance.
(f) Interpreters.--To ensure that health screenings and medical
care required under this section are carried out in the best interests
of the detainee, the Commissioner shall ensure that--
(1) language-appropriate interpretation services, including
interpretation of indigenous languages, are provided to each
detainee; and
(2) each detainee is informed of the availability of such
interpretation services.
(g) Chaperones.--To ensure that health screenings and medical care
required under this section are carried out in the best interests of
the detainee--
(1) the Commissioner shall establish guidelines for, and
ensure the presence of, chaperones for all detainees during
medical screenings and examinations in accordance with relevant
guidelines in the American Medical Association Code of Medical
Ethics and recommendations of the American Academy of
Pediatrics; and
(2) to the extent practicable, the physical examination of
a child shall always be performed in the presence of--
(A) a parent or legal guardian; or
(B) the detainee's closest present adult relative,
if a parent or legal guardian is unavailable.
(h) Documentation.--The Commissioner shall ensure that--
(1) the health screenings and medical care required under
this section and any other medical evaluations and
interventions for detainees are documented in accordance with
commonly accepted standards in the United States for medical
record documentation; and
(2) such documentation is provided to any individual who
received a health screening and subsequent medical treatment
upon release from CBP custody.
(i) Infrastructure and Equipment.--The Commissioner or the
Administrator of General Services shall ensure that each location to
which detainees are first transported after an initial encounter with
an agent or officer of CBP has--
(1) a private space that--
(A) provides a comfortable and considerate
atmosphere for the patient; and
(B) ensures the patient's dignity and right to
privacy during the health screening and medical
assessment and any necessary follow-up care;
(2) all necessary and appropriate medical equipment and
facilities--
(A) to conduct the health screenings and follow-up
care required under this section;
(B) to treat trauma;
(C) to provide emergency care, including
resuscitation of individuals of all ages; and
(D) to prevent the spread of communicable diseases;
(3) basic over-the-counter medications appropriate for all
age groups; and
(4) appropriate transportation to medical facilities in the
case of a medical emergency, or an on-call service with the
ability to arrive at the CBP facility within 30 minutes.
(j) Personnel.--The Commissioner or the Administrator of General
Services, as the case may be, shall ensure that each location to which
detainees are first transported after an initial encounter has--
(1) at least 1 licensed medical professional on site to
conduct health screenings; and
(2) other personnel that are or may be necessary for
carrying out the functions described in subsection (e), such as
licensed emergency care professionals, specialty physicians
(including physicians specializing in pediatrics, family
medicine, obstetrics and gynecology, geriatric medicine,
internal medicine, and infectious diseases), nurse
practitioners, other nurses, physician assistants, licensed
social workers, mental health professionals, public health
professionals, dieticians, interpreters, and chaperones, on
site to the extent practicable, or, if not practicable,
available on call.
(k) Ethical Guidelines.--The Commissioner shall ensure that all
medical assessments and procedures conducted pursuant to this section
are conducted in accordance with ethical guidelines in the applicable
medical field and respect human dignity.
SEC. 4. WATER, SANITATION AND HYGIENE.
The Commissioner shall ensure that all detainees have access to--
(1) not less than 1 gallon of drinking water per person per
day, in addition to any other age-appropriate fluids that may
be needed;
(2) a private, safe, clean, and reliable permanent or
portable toilet with proper waste disposal and a hand washing
station, with not fewer than 1 toilet available for every 12
male detainees, and not fewer than 1 toilet available for every
8 female detainees;
(3) a clean diaper changing facility, which includes proper
waste disposal, a hand washing station, and unrestricted access
to diapers;
(4) the opportunity to bathe daily in a permanent or
portable shower that is private and secure; and
(5) products for individuals of all age groups and for
individuals with disabilities to maintain basic personal
hygiene, including soap, a toothbrush, toothpaste, adult
diapers, feminine hygiene products, and receptacles for the
proper storage and disposal of such products.
SEC. 5. FOOD AND NUTRITION.
The Commissioner shall ensure that detainees have access to--
(1) 3 meals per day, including--
(A) for individuals 12 years of age or older, a
diet that contains not fewer than 2,000 calories per
day; and
(B) for children younger than 12 years of age, a
diet that contains an appropriate number of calories
per day based on the child's age and weight;
(2) accommodations for any dietary needs or restrictions;
and
(3) access to food in a manner that follows applicable food
safety standards.
SEC. 6. SHELTER.
The Commissioner shall ensure that in each facility at which a
detainee is detained--
(1) except as provided in paragraph (2), males and females
are detained separately;
(2) for any minor child arriving in the United States with
an adult relative or legal guardian, such child--
(A) is detained with such relative or legal
guardian unless such an arrangement poses safety or
security concerns; and
(B) if such child is detained apart from an adult
relative or legal guardian as a result of such safety
or security concerns, is not detained with adults;
(3) for any unaccompanied minor arriving in the United
States without an adult relative or legal guardian, such child
is detained in an age-appropriate facility and not detained
with adults;
(4) a detainee with a temporary or permanent disability is
held in an accessible location and in a manner that provides
for his or her safety, comfort, and security, with
accommodations provided to the extent needed;
(5) no detainee is placed in a room for any period if such
placement would exceed the maximum occupancy level as
determined by the appropriate building code, fire marshal, or
other authority;
(6) each detainee is provided with temperature appropriate
clothing and bedding;
(7) the facility is well lit and well ventilated, with the
humidity and temperature kept at comfortable levels (between 68
and 74 degrees Fahrenheit);
(8) detainees who are in custody for more than 48 hours are
given access to the outdoors for not less than 1 hour during
the daylight hours during each 24-hour period;
(9) detainees are allowed to practice their religion or to
not practice a religion, at their discretion;
(10) detainees are given access to lighting and noise
levels that are safe and conducive for sleeping throughout the
night between the hours of 10:00 p.m. and 6:00 a.m;
(11) CBP officers, employees, and contracted personnel--
(A) follow medical standards for the isolation and
prevention of communicable diseases; and
(B) ensure the physical and mental safety of
detainees who identify as lesbian, gay, bisexual,
transgender, or intersex;
(12) the facility has video monitoring--
(A) to provide for the safety of the detainees; and
(B) to prevent sexual abuse and physical harm of
vulnerable detainees;
(13) there is posted or otherwise made available in all
areas where detainees are located a language appropriate
``Detainee Bill of Rights'' (including indigenous languages),
which specifies all rights afforded to detainees under this
Act; and
(14) the facility certifies that--
(A) the video monitoring required under paragraph
(12) is properly working at all times; and
(B) the videos resulting from video monitoring are
preserved for at least 90 days.
SEC. 7. COORDINATION AND SURGE CAPACITY.
The Secretary of Homeland Security shall enter into memoranda of
understanding with appropriate Federal agencies, such as the Department
of Health and Human Services, and applicable government emergency
relief services, and shall enter into contracts with health care,
public health, social work, and transportation professionals, for
purposes of addressing surge capacity and ensuring compliance with this
Act.
SEC. 8. TRAINING.
The Commissioner shall ensure that CBP personnel assigned to each
short-term custodial facility are professionally trained, including by
receiving such continuing education as the Commissioner determines
appropriate, in all subjects necessary to ensure compliance with this
Act, including--
(1) humanitarian response protocols and standards;
(2) indicators of physical and mental illness, and medical
distress in children and adults;
(3) indicators of child sexual exploitation and effective
responses to missing migrant children; and
(4) procedures to report incidents of suspected child
sexual abuse and exploitation directly to the National Center
for Missing and Exploited Children.
SEC. 9. INTERFACILITY TRANSFER OF CARE.
(a) Transfer.--When a detainee is discharged from a medical
facility or emergency services department, the Commissioner shall
ensure that responsibility of care is transferred from the medical
facility or emergency services department to an accepting licensed CBP
health care provider.
(b) Responsibilities of Accepting Providers.--Each accepting
licensed CBP health care provider shall review the medical facility or
emergency department's evaluation, diagnosis, treatment, management,
and discharge care instructions--
(1) to assess the safety of the discharge and transfer; and
(2) to provide necessary follow-up care.
SEC. 10. PLANNING AND INITIAL IMPLEMENTATION.
(a) Planning.--Not later than 60 days after the date of the
enactment of this Act, the Secretary of Homeland Security shall submit
a detailed plan to Congress that describes the timeline, process, and
challenges of implementing the requirements under this Act.
(b) Implementation.--The Secretary of Homeland Security shall
ensure that the requirements under this Act are implemented not later
than 6 months after the date of the enactment of this Act.
SEC. 11. CONTRACTOR COMPLIANCE.
The Secretary of Homeland Security shall ensure that all personnel
contracted to carry out this Act comply with the requirements under
this Act.
SEC. 12. INSPECTIONS.
(a) In General.--The Inspector General of the Department of
Homeland Security shall--
(1) conduct unannounced inspections of ports of entry,
border patrol stations, and detention facilities administered
by CBP or contractors of CBP; and
(2) submit to Congress--
(A) reports on the results of the inspections
conducted pursuant to paragraph (1); and
(B) other reports related to custody operations.
(b) Particular Attention.--In carrying out subsection (a), the
Inspector General shall pay particular attention to--
(1) the degree of compliance by CBP with the requirements
under this Act;
(2) remedial actions taken by CBP;
(3) the health needs of detainees; and
(4) the degree of compliance with part 115 of title 6, Code
of Federal Regulations (commonly known as the ``Standards to
Prevent, Detect, and Respond to Sexual Abuse and Assault in
Confinement Facilities'').
(c) Access to Facilities.--The Commissioner may not deny a Member
of Congress entrance to any facility or building used, owned, or
operated by CBP.
SEC. 13. GOVERNMENT ACCOUNTABILITY OFFICE REPORT.
(a) In General.--The Comptroller General of the United States--
(1) not later than 6 months after the date of the enactment
of this Act, shall commence a study on implementation of, and
compliance with, this Act; and
(2) not later than 1 year after the date of the enactment
of this Act, shall submit a report to Congress containing the
results of the study required under paragraph (1).
(b) Issues To Be Studied.--The study required under subsection
(a)(1) shall examine--
(1) the management and oversight by CBP of ports of entry,
border patrol stations, and other detention facilities,
including the extent to which CBP and the Department of
Homeland Security have effective processes in place to comply
with the requirements under this Act; and
(2) the extent to which CBP personnel, in carrying out this
Act, make abusive, derisive, profane, or harassing statements
or gestures, or engage in any other conduct evidencing hatred
or invidious prejudice to or about 1 person or group on account
of race, color, religion, national origin, sex, sexual
orientation, age, or disability, including on social media.
SEC. 14. PUBLICATION OF DATA ON COMPLAINTS OF SEXUAL ABUSE AT U.S.
CUSTOMS AND BORDER PROTECTION FACILITIES.
Not later than 90 days after the date of the enactment of this Act,
the Secretary of Homeland Security, acting in coordination with the
Office of Inspector General and the Office for Civil Rights and Civil
Liberties of the Department of Homeland Security, shall publicly
release aggregate data on complaints of sexual abuse at CBP facilities
on its website on a quarterly basis, excluding any personally
identifiable information that may compromise the confidentiality of
individuals who reported such abuse.
SEC. 15. RULES OF CONSTRUCTION.
Nothing in this Act may be construed as--
(1) authorizing CBP to detain individuals for longer than
72 hours;
(2) contradicting the March 7, 2014, Department of Homeland
Security rule adopting Standards to Prevent, Detect, and
Respond to Sexual Abuse and Assault in Confinement Facilities,
which includes a zero tolerance policy prohibiting all forms of
sexual abuse and assault of individuals in U.S. Customs and
Border Protection custody, including in holding facilities,
during transport, and during processing;
(3) contradicting current protocols related to Department
of Homeland Security background checks in the hiring process;
(4) restricting the Department of Homeland Security from
denying employment to, or terminating the employment of, any
individual who--
(A) would be or is involved with the handling or
processing at holding facilities, during transport, or
during processing, or care of detainees, including the
care of children; and
(B) has been convicted of a sex crime or other
offense involving a child victim; or
(5) affecting the obligation to fully comply with all
applicable immigration laws, including being subject to any
penalties, fines, or other sanctions.
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