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116th Congress }                                          { Rept. 116-162
                        HOUSE OF REPRESENTATIVES
 1st Session   }                                          { Part 1

======================================================================
 
HUMANITARIAN STANDARDS FOR INDIVIDUALS IN CUSTOMS AND BORDER PROTECTION 
                              CUSTODY ACT

                                _______
                                

 July 19, 2019.--Committed to the Committee of the Whole House on the 
              State of the Union and ordered to be printed

                                _______
                                

    Mr. Nadler, from the Committee on the Judiciary, submitted the 
                               following

                              R E P O R T

                             together with

                            DISSENTING VIEWS

                        [To accompany H.R. 3239]

    The Committee on the Judiciary, to whom was referred the 
bill (H.R. 3239) to require U.S. Customs and Border Protection 
to perform an initial health screening on detainees, and for 
other purposes, having considered the same, report favorably 
thereon with an amendment and recommend that the bill as 
amended do pass.

                                CONTENTS

                                                                   Page
Purpose and Summary..............................................     6
Background and Need for the Legislation..........................     6
Hearings.........................................................     9
Committee Consideration..........................................    10
Committee Votes..................................................    10
Committee Oversight Findings.....................................    20
New Budget Authority and Tax Expenditures and Congressional 
  Budget Office Cost Estimate....................................    20
Duplication of Federal Programs..................................    20
Performance Goals and Objectives.................................    20
Advisory on Earmarks.............................................    20
Section-by-Section Analysis......................................    20
Committee Correspondence.........................................    24
Dissenting Views.................................................    26

    The amendment is as follows:
  Strike all after the enacting clause and insert the 
following:

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

  (a) Short Title.--This Act may be cited as the ``Humanitarian 
Standards for Individuals in Customs and Border Protection Custody 
Act''.
  (b) Table of Contents.--The table of contents of this Act is as 
follows:

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. Rule of construction.
Sec. 14. Definitions.

SEC. 2. INITIAL HEALTH SCREENING PROTOCOL.

  (a) In General.--The Commissioner of U.S. Customs and Border 
Protection (referred to in this Act as 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 individuals in the custody of U.S. Customs 
and Border Protection (referred to in this Act as ``CBP''), as required 
under this section.
  (b) Initial Screening and Medical Assessment.--The Commissioner shall 
ensure that any individual who is detained in the custody of CBP 
(referred to in this Act as a ``detainee'') receives 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 healthcare 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 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 under 12 years of 
                age;
                  (E) a physical examination; and
                  (F) a risk-assessment and the development of a plan 
                for monitoring and care, when appropriate.
          (2) Prescription medication.--The medical professional shall 
        review any prescribed medication that is in the detainee's 
        possession or that was confiscated by CBP upon arrival and 
        determine if the medication may be kept by the detainee for use 
        during detention, properly stored by CBP with appropriate 
        access for use during detention, or maintained with the 
        detained individual's personal property. 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 shall 
        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 described in subsections (b) and (c) 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 
        reasonably self-identifies as having a medical condition that 
        requires prompt medical attention or is--
                  (A) exhibiting signs of acute or potentially severe 
                physical or mental illness, or otherwise has an acute 
                or chronic physical or mental disability or illness;
                  (B) pregnant;
                  (C) a child (with priority given, as appropriate, to 
                the youngest children); or
                  (D) elderly.
  (e) Further Care.--
          (1) In general.--If, as a result of the initial health 
        screening and medical assessment, the licensed medical 
        professional conducting the screening or assessment determines 
        that one 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) Re-evaluation.--
                  (A) In general.--Detainees described in paragraph (1) 
                shall be re-evaluated within 24 hours and monitored 
                thereafter as determined by an emergency care 
                professional (and in the care of a consultation 
                provided to a child, with a licensed emergency care 
                professional with a background in pediatric care).
                  (B) Reevaluation prior to transportation.--In 
                addition to the re-evaluations under subparagraph (A), 
                detainees shall have all vital signs re-evaluated and 
                be cleared as safe to travel by a medical professional 
                prior to transportation.
          (3) Pyschological 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 language-appropriate 
interpretation services, including indigenous languages, are provided 
to each detainee and that each detainee is informed of the availability 
of 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 consistent 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 parent or 
        legal guardian or in the presence of the detainee's closest 
        present adult relative if a parent or legal guardian is 
        unavailable.
  (h) Documentation.--The Commissioner shall ensure that the health 
screenings and medical care required under this section, along with any 
other medical evaluations and interventions for detainees, are 
documented in accordance with commonly accepted standards in the United 
States for medical record documentation. Such documentation shall be 
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 the following:
          (1) A private space that provides a comfortable and 
        considerate atmosphere for the patient and that 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 to conduct the health screenings and follow-up care 
        required under this section, to treat trauma, to provide 
        emergency care, including resuscitation of individuals of all 
        ages, and to prevent the spread of communicable diseases.
          (3) Basic over-the-counter medications appropriate for all 
        age groups.
          (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 shall ensure that each location to which detainees are first 
transported after an initial encounter has onsite at least one licensed 
medical professional to conduct health screenings. 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, shall be located on site to the extent practicable, or 
if not practicable, shall be 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. 3. WATER, SANITATION AND HYGIENE.

  The Commissioner shall ensure that detainees have access to--
          (1) not less than one gallon of drinking water per person per 
        day, and age-appropriate fluids as needed;
          (2) a private, safe, clean, and reliable permanent or 
        portable toilet with proper waste disposal and a hand washing 
        station, with not less than one toilet available for every 12 
        male detainees, and 1 toilet 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 with 
        disabilities to maintain basic personal hygiene, including 
        soap, a toothbrush, toothpaste, adult diapers, and feminine 
        hygiene products, as well as receptacles for the proper storage 
        and disposal of such products.

SEC. 4. FOOD AND NUTRITION.

  The Commissioner shall ensure that detainees have access to--
          (1) three meals per day including--
                  (A) in the case of an individual age 12 or older, a 
                diet that contains not less than 2,000 calories per 
                day; and
                  (B) in the case of a child who is under the age of 
                12, 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. 5. SHELTER.

  The Commissioner shall ensure that each facility at which a detainee 
is detained meets the following requirements:
          (1) Except as provided in paragraph (2), males and females 
        shall be detained separately.
          (2) In the case of a minor child arriving in the United 
        States with an adult relative or legal guardian, such child 
        shall be detained with such relative or legal guardian unless 
        such an arrangement poses safety or security concerns. In no 
        case shall a minor who is detained apart from an adult relative 
        or legal guardian as a result of such safety or security 
        concerns be detained with other adults.
          (3) In the case of an unaccompanied minor arriving in the 
        United States without an adult relative or legal guardian, such 
        child shall be detained in an age-appropriate facility and 
        shall not be detained with adults.
          (4) A detainee with a temporary or permanent disability shall 
        be held in an accessible location and in a manner that provides 
        for his or her safety, comfort, and security, with 
        accommodations provided as needed.
          (5) No detainee shall be placed in a room for any period of 
        time if the detainee's placement would exceed the maximum 
        occupancy level as determined by the appropriate building code, 
        fire marshal, or other authority.
          (6) Each detainee shall be provided with temperature 
        appropriate clothing and bedding.
          (7) The facility shall be 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 shall 
        have access to the outdoors for not less than 1 hour during the 
        daylight hours during each 24-hour period.
          (9) Detainees shall have the ability to practice their 
        religion or not to practice a religion, as applicable.
          (10) Detainees shall have access to lighting and noise levels 
        that are safe and conducive for sleeping throughout the night 
        between the hours of 10 p.m. and 6 a.m.
          (11) Officers, employees, and contracted personnel of CBP 
        shall--
                  (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, and intersex.
          (12) The facility shall have video-monitoring to provide for 
        the safety of the detained population and to prevent sexual 
        abuse and physical harm of vulnerable detainees.
          (13) The Commissioner shall ensure that language-appropriate 
        ``Detainee Bill of Rights'', including indigenous languages, 
        are posted or otherwise made available in all areas where 
        detainees are located. The ``Detainee Bill of Rights'' shall 
        include all rights afforded to the detainee under this Act.
          (14) Video from video-monitoring must be preserved for 90 
        days and the detention facility must maintain certified records 
        that the video-monitoring is properly working at all times.

SEC. 6. 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 emergency government 
relief services, as well as contracts with health care, public health, 
social work, and transportation professionals, for purposes of 
addressing surge capacity and ensuring compliance with this Act.

SEC. 7. TRAINING.

  The Commissioner shall ensure that CBP personnel assigned to each 
short-term custodial facility are professionally trained, including 
continuing education as the Commissioner deems 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. 8. INTERFACILITY TRANSFER OF CARE.

  (a) Transfer.--When a detainee is discharged from a medical facility 
or emergency department, the Commissioner shall ensure that 
responsibility of care is transferred from the medical facility or 
emergency department to an accepting licensed health care provider of 
CBP.
  (b) Responsibilities of Accepting Providers.--Such accepting licensed 
health care provider shall review the medical facility or emergency 
department's evaluation, diagnosis, treatment, management, and 
discharge care instructions to assess the safety of the discharge and 
transfer and to provide necessary follow-up care.

SEC. 9. PLANNING AND INITIAL IMPLEMENTATION.

  (a) Planning.--Not later than 60 days after the date of enactment of 
this Act, the Secretary of Homeland Security shall submit to Congress a 
detailed plan delineating the timeline, process, and challenges of 
carrying out the requirements of this Act.
  (b) Implementation.--The Secretary of Homeland Security shall ensure 
that the requirements of this Act are implemented not later than 6 
months after the date of enactment.

SEC. 10. CONTRACTOR COMPLIANCE.

  The Secretary of Homeland Security shall ensure that all personnel 
contracted to carry out this Act do so in accordance with the 
requirements of this Act.

SEC. 11. 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, reports on the results of such 
        inspections as well as other reports of the Inspector General 
        related to custody operations.
  (b) Particular Attention.--In carrying out subsection (a), the 
Inspector General of the Department of Homeland Security shall pay 
particular attention to--
          (1) the degree of compliance by CBP with the requirements of 
        this Act;
          (2) remedial actions taken by CBP; and
          (3) the health needs of detainees.
  (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. 12. GAO REPORT.

  (a) In General.--The Comptroller General of the United States shall--
          (1) not later than 6 months after the date of enactment of 
        this Act, commence a study on implementation of, and compliance 
        with, this Act; and
          (2) not later than 1 year after the date of enactment of this 
        Act, submit a report to Congress on the results of such study.
  (b) Issues to Be Studied.--The study required by subsection (a) shall 
examine 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 this Act. The study shall also 
examine 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 one person or group on account of race, color, religion, 
national origin, sex, sexual orientation, age, or disability, including 
on social media.

SEC. 13. RULE OF CONSTRUCTION.

  Nothing in this Act shall be construed to authorize CBP to detain 
individuals for longer than 72 hours.

SEC. 14. DEFINITIONS.

  In this Act:
          (1) Interpretation services.--The term ``interpretation 
        services'' includes translation services that are performed 
        either in-person or through a telephone or video service.
          (2) Child.--The term ``child'' has the meaning given the term 
        in section 101(b)(1) of the Immigration and Nationality Act (8 
        U.S.C. 1101(b)(1)).
          (3) 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.
          (4) Forward operating base.--The term ``forward operating 
        base'' means a permanent facility established by CBP in forward 
        or remote locations, and designated as such by CBP.

                          Purpose and Summary

    H.R. 3239, the ``Humanitarian Standards for Individuals in 
Customs and Border Protection Custody Act,'' requires U.S. 
Customs and Border Protection (CBP) to ensure that its border 
facilities are equipped to meet and deliver basic humanitarian 
standards of care for detained individuals, including families 
and children.

                Background and Need for the Legislation

    Most Border Patrol facilities and ports of entry were 
designed to hold adult single men, given that for years the 
vast majority of individuals apprehended at the Southern border 
were Mexican men seeking employment opportunities in the United 
States. Over the last few years, however, the situation at the 
border has changed with significant numbers of unaccompanied 
children and family units coming to the border and turning 
themselves over to CBP. This current fiscal year, apprehensions 
have spiked compared to recent years.
    CBP officials, for example, consider CBP to be ``at 
capacity'' when 4,000 individuals are in the agency's custody 
at any one time. Between May 14 and June 13, 2019, however, CBP 
detained more than 14,000 people per day--and sometimes as many 
as 18,000.\1\ Overall, from March 2019 to June 2019, almost 
400,000 individuals were apprehended at the Southern border; 
more than double the number of apprehensions made during the 
same period in the previous year.\2\
---------------------------------------------------------------------------
    \1\Dara Lind, The Horrifying Conditions Facing Kids in Border 
Detention, Explained, VOX (June 25, 2019), https://www.vox.com/policy-
and-politics/2019/6/25/18715725/children-border-detention-kids-cages-
immigration; Cedar Attanasio, Garance Burke, Attorneys: Texas Border 
Facility is Neglecting Migrant Kids, Associated Press (June 21, 2019), 
https://www.apnews.com/46da2dbe04f54adbb875cfbc06bbc615.
    \2\Customs and Border Protection, Southwest Border Migration 
FY2019, Dep't of Homeland Security (last modified July 10, 2019), 
https://www.cbp.gov/newsroom/stats/sw-border-migration; see also David 
Bier, Decline in June Border Patrol Apprehensions Tracks Prior Years' 
Patterns, CATO Institute (July 9, 2019), https://www.cato.org/blog/
decline-june-apprehensions-track-prior-years-patterns.
---------------------------------------------------------------------------
    So far this fiscal year, CBP has reported the deaths of 
three children and seven adults in agency custody.\3\ The 
conditions that contributed to these tragic incidents should 
not have come as a surprise. In a December 2018 appearance 
before the Senate Judiciary Committee, then-CBP Commissioner 
Kevin McAleenan testified that CBP's short-term holding 
facilities are ``incompatible'' with the increasing migration 
of family units and unaccompanied children.''\4\
---------------------------------------------------------------------------
    \3\ Email received from Megan Ilnicky, Office of Congressional 
Affairs, Customs and Border Protection, on July 10, 2019 (on file with 
Committee); see also Camilo Montoya-Galvez, Top Border Protection 
Official is ``Confident'' in Agency's Data on Migrant Child Deaths, CBS 
NEWS (May 23, 2019), https://www.cbsnews.com/news/migrant-child-deaths-
top-customs-and-border-protection-official-is-confident-in-agency-data-
on-migrant-child-deaths/.
    \4\Nick Miroff & Robert Moore, 7-year-old Migrant Girl Taken into 
Border Patrol Custody Dies of Dehydration, Exhaustion, Washington Post 
(Dec. 13, 2018), https://www.washingtonpost.com/world/national-
security/7-year-old-migrant-girl-taken-into-border-patrol-custody-dies-
of-dehydration-exhaustion/2018/12/13/8909e356-ff03-11e8-862a-
b6a6f3ce8199_story.html?utm_term=.8d6319c9c800.
---------------------------------------------------------------------------
    On May 30, 2019, the Department of Homeland Security's 
Office of Inspector General (DHS OIG) issued the first of two 
``Management Alerts'' on the conditions experienced by 
children, families, and adults in the six busiest CBP custody 
facilities in Texas.\5\ The May 30 Alert primarily focused on 
dangerous overcrowding of single adults at the Del Norte 
Processing Center, and documented, among other things, the 
following concerns:
---------------------------------------------------------------------------
    \5\DHS Office of Inspector General, Management Alert--DHS Needs to 
Address Dangerous Overcrowding Among Single Adults at El Paso Del Norte 
Processing Center, Dep't of Homeland Security, OIG-19-49 (May 30, 
2019), https://www.oig.dhs.gov/sites/default/files/assets/2019-05/OIG-
19-46-May19.pdf.
---------------------------------------------------------------------------
           On May 7 and 8, some 750 and 900 individuals 
        respectively were detained in a facility with a maximum 
        capacity of 125.
           A cell with a maximum capacity of 12 held 76 
        detainees; a cell with a maximum capacity of 8 held 41 
        detainees; and a cell with a maximum capacity of 35 
        held 155 detainees.
           Border Patrol agents told DHS inspectors 
        that some of the individuals had been held in standing-
        room-only conditions for days or weeks.
           With limited access to showers and clean 
        clothing, individuals were wearing soiled clothing for 
        days or weeks.
           Individuals were standing on toilets in the 
        cells to make room and gain breathing space, thus 
        limiting access to the toilets.
    DHS reviewed and responded to the Alert before it was 
published, and formal comments were incorporated by DHS OIG. 
While DHS concurred with the recommendation made to alleviate 
overcrowding at the Del Norte Processing Center, it identified 
November 30, 2020 as the date on which the situation would be 
corrected. As a result, DHS OIG considered the recommendation 
open and unresolved, as ``DHS's corrective action is critical 
to the immediate health and safety needs of detainees, who 
cannot continue to be held in standing-room-only conditions for 
weeks until additional tents are constructed.''\6\
---------------------------------------------------------------------------
    \6\Id. at 1.
---------------------------------------------------------------------------
    On July 2, 2019, DHS OIG issued a second ``Management 
Alert'' focused on the dangerous overcrowding and prolonged 
detention of children and adults at five CBP custody facilities 
in the Rio Grande Valley.\7\ This Alert documented, among other 
things, the following concerns:
---------------------------------------------------------------------------
    \7\DHS Office of Inspector General, Management Alert--DHS Needs to 
Address Dangerous Overcrowding and Prolonged Detention of Children and 
Adults in the Rio Grande Valley, Dep't of Homeland Security, OIG-19-51 
(July 2, 2019), https://www.oig.dhs.gov/sites/default/files/assets/
2019-07/OIG-19-51-Jul19_.pdf.
---------------------------------------------------------------------------
           Border Patrol was holding about 8,000 
        detainees in custody at the time of the visit, with 
        3,400 detainees held longer than the 72 hours generally 
        permitted under the CBP Transport, Escort, Detention, 
        and Search (TEDS) standards.\8\ Of those 3,400 
        detainees, Border Patrol was holding 1,500 for more 
        than ten days.
---------------------------------------------------------------------------
    \8\Id.
---------------------------------------------------------------------------
           Border Patrol data indicated that 826 (31 
        percent) of the 2,669 children at these facilities were 
        being held longer than the 72 hours generally permitted 
        under the TEDS standards and the Flores Agreement.\9\
---------------------------------------------------------------------------
    \9\The Flores Settlement Agreement generally prohibits the 
detention of minors for longer than 72 hours. In the case of an influx 
of minors, placement should be as expeditious as possible (Jenny 
Lissette Flores v. Reno, Case No. 85-4544-RJK (C.D. CA 1997). 8 U.S.C. 
Sec.  1232(b)(3) requires DHS to meet this timeline unless there are 
``exceptional circumstances.'' The Flores Agreement also requires 
facilities that hold minors to provide: (1) access to food and drinking 
water; (2) medical assistance in the event of emergencies; (3) toilets 
and sinks; (4) adequate temperature control and ventilation; (5) 
adequate supervision to protect minors from others; (6) separation from 
unrelated adults whenever possible; and (7) contact with family members 
who were arrested with the minor.
---------------------------------------------------------------------------
           Of the 1,031 unaccompanied children held at 
        the Centralized Processing Center in McAllen, Texas, 
        806 had already been processed and were awaiting 
        transfer to HHS custody. Of those 806 children, 165 had 
        been in custody longer than a week.
           Among more than 50 unaccompanied children 
        younger than seven years old, some had been in custody 
        more than two weeks while awaiting transfer.
           Although TEDS standards require CBP to make 
        a reasonable effort to provide a shower for adults 
        after 72 hours, most single adults had not had a shower 
        in CBP custody, despite several being held for as long 
        as a month.
           Most single adults were wearing the same 
        clothes they were wearing when they arrived days, 
        weeks, and even up to a month earlier.
    DHS reviewed and responded to the Alert before it was 
published, and formal comments were incorporated by DHS OIG. 
DHS responded by citing measures taken to expand CBP's capacity 
on the Southern border. DHS OIG recognized the ``extraordinary 
challenges'' facing CBP, but stated that it ``remained 
concerned that DHS is not taking sufficient measures to address 
prolonged detention in CBP custody among single adults. 
Although an additional 500 beds in the Rio Grande Valley may 
reduce overcrowding among single adults, DHS must transfer 
single adults to ICE custody as quickly as possible; within 
DHS, long-term detention is ICE's responsibility.''\10\
---------------------------------------------------------------------------
    \10\See supra note 7 at 10.
---------------------------------------------------------------------------
    These reports are troubling, but unfortunately they are not 
isolated incidents. Members of Congress, doctors, lawyers, and 
journalists have also documented the disturbing conditions in 
other facilities in which many children are held. Observations 
and allegations include children being forced to wear 
``clothing stained with vomit''\11\ and to share combs during a 
lice outbreak.\12\ According to members of the American 
Association of Pediatricians, which met with children in CBP 
custody in June, ``the smell of sweat, urine and feces'' was 
the first thing that hit them when they walked in the door.\13\ 
In June 2019, the Associated Press (AP) detailed conditions 
inside a CBP facility in Clint, Texas, where an estimated 250 
to 300 children, including some infants, were being held.\14\ 
According to the AP, the facility lacked adequate food, water, 
and sanitation, while ``teen mothers and other younger kids 
[were] being asked to care for infants and toddlers on their 
own, with little or no help from any adults.''\15\
---------------------------------------------------------------------------
    \11\Simon Romero, `Don't Talk to Her': We Toured the Troubled 
Border Station Housing Migrant Children, The N.Y. Times (June 26, 
2019), https://www.nytimes.com/2019/06/26/us/migrant-children-border-
clint-texas.html.
    \12\Isaac Chotiner, Inside a Texas Building Where the Government is 
Holding Immigrant Children, The New Yorker (June 22, 2019), https://
www.newyorker.com/news/q-and-a/inside-a-texas-building-where-the-
government-is-holding-immigrant-children.
    \13\Elizabeth Cohen, Pediatricians Share Migrant Children's 
Disturbing Drawings of Their Time in US Custody, CNN (July 4, 2019), 
https://www.cnn.com/2019/07/03/health/migrant-drawings-cbp-children/
index.html.
    \14\A Firsthand Report of `Inhumane Conditions' at a Migrant 
Children's Detention Facility,'' PBS Newshour (June 21, 2019), https://
www.pbs.org/newshour/show/a-firsthand-report-of-inhumane-conditions-at-
a-migrant-childrens-detention-facility.
    \15\Id.
---------------------------------------------------------------------------
    Last week, Vice President Mike Pence visited a Border 
Patrol station in McAllen, Texas where individuals in CBP 
custody told reporters they had been there for 40 days, were 
hungry, and did not have ready access to water.\16\ Vice 
President Pence said he was ``not surprised by what he saw'' 
and added, ``this is tough stuff.''\17\
---------------------------------------------------------------------------
    \16\Josh Dawsey & Colby Itkowitz, `This is Tough Stuff': At Texas 
Detention Facility Pence Sees Hundreds of Migrants Crammed with No 
Beds, Wash. Post (July 12, 2019), https://www.washingtonpost.com/
politics/pence-tours-detention-facilities-at-the-border-defends-
administrations-treatment-of-migrants/2019/07/12/993f54e0-a4bc-11e9-
b8c8-75dae2607e60_story.html?utm_term=.e7ccf3be4208.
    \17\Id.
---------------------------------------------------------------------------

                                Hearings

    For the purposes of section 103(i) of H. Res. 6 of the 
116th Congress, the following hearing was used to develop H.R. 
3239: ``Dangerous Overcrowding and Prolonged Detention at CBP 
Facilities,'' held before the Subcommittee on Immigration and 
Citizenship on July 15, 2019. The Subcommittee heard testimony 
from Diana Shaw, Assistant Inspector General for Special 
Reviews and Evaluation, Office of Inspector General, Department 
of Homeland Security (DHS). The witness's testimony centered on 
the two Management Alerts issued by DHS OIG in May and July 
2019, discussed above. The witness described in additional 
detail the overcrowded conditions at the inspected facilities; 
the prolonged detention of unaccompanied children, families, 
and adults documented in each report; and the conditions at 
other facilities mentioned in reports by various media 
outlets.\18\
---------------------------------------------------------------------------
    \18\See e.g., A Firsthand Report of `Inhumane Conditions' at a 
Migrant Children's Detention Facility,'' PBS Newshour (June 21, 2019), 
https://www.pbs.org/newshour/show/a-firsthand-report-of-inhumane-
conditions-at-a-migrant-childrens-detention-facility; Rafael Carranza, 
Reports of Misconduct and Sexual Assault of Migrant Kids Surface at 
Yuma Border Facility, Arizona Republic (July 9, 2019), https://
www.azcentral.com/story/news/politics/border-issues/2019/07/09/reports-
abuse-migrant-kids-surface-yuma-border-facility/1689876001/.
---------------------------------------------------------------------------

                        Committee Consideration

    On July 17, 2019, the Committee met in open session and 
ordered the bill, H.R. 3239, favorably reported with an 
amendment in the nature of a substitute by a rollcall vote of 
18 to 13, a quorum being present.

                            Committee Votes

    In compliance with clause 3(b) of rule XIII of the Rules of 
the House of Representatives, the Committee advises that the 
following rollcall votes occurred during the Committee's 
consideration of H.R. 3239:
    1. An amendment by Mr. Biggs to amend Section 5 to allow a 
child to be detained with an adult when the adult is a 
``parent'' instead of an ``adult relative'' or ``relative'' was 
defeated by a roll call vote of 8 to 21.


    2. An amendment by Ms. Jackson Lee to: (1) require the 
preservation of video recordings from monitoring devices for 90 
days and to require CBP to maintain certified records that 
video monitoring equipment is properly working at all times; 
and (2) ensure that language-appropriate ``Detainee Bill of 
Rights'' information is posted or otherwise made available in 
all areas where detainees are located was passed by a roll call 
vote of 18 to 12.


    3. An amendment by Mr. Steube to amend Section 9 to provide 
that the Secretary of Homeland Security ensure that this Act is 
implemented not later than 6 months after the date of its 
enactment provided Congress has appropriated an amount of funds 
sufficient to carry out the Act's requirements was defeated by 
a roll call vote of 9 to 17.


    4. An amendment by Mr. Gaetz to express the sense of 
Congress that the provisions of the bill require additional 
resources and personnel for the CBP and that the House of 
Representatives should pass supplemental funding for the CBP to 
mitigate the humanitarian crisis at the Southern border and to 
implement this legislation quickly and effectively was defeated 
by a roll call vote of 9 to 17.


    5. Motion to report H.R. 3239, as amended, was agreed to by 
a roll call vote of 18 to 13.


                      Committee Oversight Findings

    In compliance with clause 3(c)(1) of rule XIII of the Rules 
of the House of Representatives, the Committee advises that the 
findings and recommendations of the Committee, based on 
oversight activities under clause 2(b)(1) of rule X of the 
Rules of the House of Representatives, are incorporated in the 
descriptive portions of this report.

  New Budget Authority and Tax Expenditures and Congressional Budget 
                          Office Cost Estimate

    With respect to the requirements of clause 3(c)(2) of rule 
XIII of the Rules of the House of Representatives and section 
308(a) of the Congressional Budget Act of 1974 and with respect 
to requirements of clause (3)(c)(3) of rule XIII of the Rules 
of the House of Representatives and section 402 of the 
Congressional Budget Act of 1974, the Committee has requested 
but not received a cost estimate for this bill from the 
Director of Congressional Budget Office. The Committee has 
requested but not received from the Director of the 
Congressional Budget Office a statement as to whether this bill 
contains any new budget authority, spending authority, credit 
authority, or an increase or decrease in revenues or tax 
expenditures.

                    Duplication of Federal Programs

    No provision of H.R. 3239 establishes or reauthorizes a 
program of the federal government known to be duplicative of 
another federal program, a program that was included in any 
report from the Government Accountability Office to Congress 
pursuant to section 21 of Public Law 111-139, or a program 
related to a program identified in the most recent Catalog of 
Federal Domestic Assistance.

                    Performance Goals and Objectives

    The Committee states that pursuant to clause 3(c)(4) of 
rule XIII of the Rules of the House of Representatives, H.R. 
3239 would require CBP to ensure that its border facilities are 
equipped to meet and deliver basic humanitarian standards of 
care for detained individuals, including families and children.

                          Advisory on Earmarks

    In accordance with clause 9 of rule XXI of the Rules of the 
House of Representatives, H.R. 3239 does not contain any 
congressional earmarks, limited tax benefits, or limited tariff 
benefits as defined in clause 9(d), 9(e), or 9(f) of Rule XXI.

                      Section-by-Section Analysis

    The following discussion describes the bill as reported by 
the Committee.
    Sec. 1. Short Title. Section 1(a) sets forth the short 
title of the bill as the ``Humanitarian Standards for 
Individuals in Customs and Border Protection Custody Act''. 
Section 1(b) sets forth the table of contents for the Act.
    Sec. 2. Initial Health Screening Protocol. Section 2(a) 
requires the Commissioner of U.S. Customs and Border Protection 
(CBP), 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 the delivery 
of health care to children, to develop guidelines for the 
provision of health screenings and medical care for individuals 
in CBP custody.
    Section 2(b) states that each individual in CBP custody 
shall receive an in-person screening by a licensed medical 
professional to assess and identify any illness, condition, or 
trauma-related symptoms, including the identification of acute 
conditions and high-risk vulnerabilities, and ensure that 
appropriate care is provided.
    Section 2(c) describes the screening process, which must 
include: an interview and intake questionnaire; screening of 
vital signs; screening of blood glucose, for known or suspected 
diabetics; weight assessment of detainees under 12 years of 
age; a physical exam; and a risk assessment and the development 
of a plan for monitoring and care, as appropriate. The medical 
professional must review any prescribed medications in the 
possession of the detainee to determine if the medication may 
be kept by the detainee, stored by CBP for use as prescribed, 
or maintained with the detainee's property. Detainees may not 
be denied the use of necessary and appropriate medication to 
manage an illness.
    Section 2(d) states that, in general, detainees are to 
receive a health screening within 12 hours of arrival at a CBP 
facility. The following high-priority populations are to 
receive a health screening within six hours of arrival: 
detainees who reasonably self-identify as having a medical 
condition that requires prompt attention; detainees exhibiting 
signs of acute or potentially severe physical or mental 
illness, or who otherwise have an acute or chronic physical or 
mental illness or disability; pregnant women; children; and 
elderly detainees.
    Section 2(e) states that if the initial health screening 
reveals vital sign measurements significantly outside of normal 
ranges, or if the detainee is identified as high-risk or in 
need of medical intervention, the detainee shall be provided 
with an in-person or technology-facilitated medical 
consultation with a licensed emergency care professional. The 
detainee will be re-evaluated within 24 hours and monitored 
thereafter as determined by an emergency care professional. 
Detainees must be cleared to travel before they can be 
transported. Detainees who have experienced physical or sexual 
violence or who have experienced events that may cause severe 
trauma or toxic stress shall be provided access to basic 
psychological assistance.
    Section 2(f) requires CBP to provide detainees with 
interpretation services during the screening and follow-up 
procedures, and inform detainees that such services are 
available.
    Section 2(g) requires CBP to have chaperones available 
during medical screenings and examinations in accordance with 
American Medical Association guidelines.
    Section 2(h) requires CBP to document health screenings and 
any medical care provided, and to provide such documents to an 
individual who receives a health screening and subsequent 
medical treatment upon their release from CBP custody.
    Section 2(i) requires each CBP facility where detainees are 
first transported to have: a private space to conduct health 
screenings and follow-up care; all necessary equipment to 
conduct the health screening and follow-up care, to treat 
trauma, provide emergency care, and prevent the spread of 
communicable diseases; basic over-the-counter medications for 
all ages; and transportation to a medical facility in the case 
of a medical emergency, or an on-call service with the ability 
to arrive at the CBP facility within 30 minutes.
    Section 2(j) requires each CBP facility where detainees are 
first transported to have at least one licensed medical 
professional to conduct health screenings on site. Other 
personnel who are or may be necessary for carrying out the 
functions described in this section such as licensed emergency 
care professionals, specialty physicians, interpreters, and 
chaperones-shall be located on site to the extent practicable, 
or if not practicable, shall be available on call.
    Section 2(k) requires all medical assessments and 
procedures to be conducted in accordance with ethical 
guidelines in the applicable medical field and with respect for 
human dignity.
    Sec. 3. Water, Sanitation, and Hygiene. Section 3 requires 
CBP to ensure that detainees have access to: at least one 
gallon of drinking water per person per day; a private, safe, 
clean, and reliable toilet with proper waste disposal and a 
hand washing station (one toilet per every 12 male detainees; 
one toilet per every eight female detainees); a clean diaper 
changing facility; the opportunity to bathe daily in a private 
and secure shower; products to maintain basic personal hygiene 
including but not limited to soap, toothbrush, toothpaste, 
feminine products, and diapers.
    Sec. 4. Food and Nutrition. Section 4 requires CBP to 
provide detainees with access to three meals a day, with 
accomodations for dietary needs or restrictions (at least 2,000 
calories a day for adults and an age- and weight-appropriate 
number of calories for children under the age of 12).
    Sec. 5. Shelter. Section 5 requires CBP to ensure that each 
facility at which an individual is detained meets the following 
requirements: (1) males and females shall be detained 
separately; (2) minor children who arrive with an adult 
relative or legal guardian shall be detained with the relative 
or guardian, unless there are safety or security concerns; (3) 
children who arrive without an adult relative or legal guardian 
(or who are separated from an adult relative or guardian 
because of safety or security concerns) shall not be detained 
with adults; (4) detainees with a temporary or permanent 
disabililty shall be held in an accessible location and in a 
manner that provides safety, comfort, and security, with 
accomodations provided as needed; (5) detainees may not be 
placed in a room for any period of time if placement would 
exceed the room's maximum occupancy level; (6) detainees shall 
be provided temperature-appropriate clothing and bedding; (7) 
facilities must be well-lit and ventilated and kept at 
comfortable temperature levels; (8) detainees who are held more 
than 48 hours must have outdoor access during daylight hours 
for 1 hour per day; (9) detainees shall have the ability to 
practice their religion; (10) detainees shall have access to 
lighting and noise levels that are safe and conducive for 
sleeping throughout the night; (11) CBP shall follow medical 
standards to isolate and prevent communicable diseases and 
ensure the safety of individuals who identify as lesbian, gay, 
bisexual, transgender, or intersex; and (12) facilities shall 
have video-monitoring to provide for the safety of detainees 
and to prevent sexual abuse and physical harm of vulnerable 
detainees.
    Recordings from video monitoring devices shall be preserved 
for 90 days, and facilities must maintain certified records 
that video monitoring equipment is properly working at all 
times. CBP must also ensure that language-appropriate Detainee 
Bill of Rights information is posted or otherwise made 
available to detainees.
    Sec. 6. Coordination and Surge Capacity. Section 6 requires 
CBP to enter into memoranda of understanding with appropriate 
federal agencies and applicable emergency government relief 
services--as well as contracts with health care, public health, 
social work, and transportation professionals--to address surge 
capacity and ensure compliance with the Act.
    Sec. 7. Training. Section 7 requires the training of CBP 
personnel on humanitarian response protocols and standards; 
indicators of physical and mental illness, and medical distress 
in children and adults; indicators of child sexual exploitation 
and effective responses to missing migrant children; and 
procedures to report incidents of suspected child sexual abuse 
and exploitation.
    Sec. 8. Interfacility Transfer of Care. Section 8 requires 
CBP to ensure that responsibility of care is transferred from a 
medical facility or emergency department to a CBP licensed 
health care provider. The accepting healthcare provider shall 
review all relevant records from the prior facility to assess 
the safety of the discharge and transfer, and to provide 
necessary follow-up care.
    Sec. 9. Implementation Plan. Section 9 requires the 
Secretary of Homeland Security to submit a plan to Congress 60 
days after the date of enactment, delineating the timeline, 
process, and challenges of carrying out these requirements, and 
to implement the Act's requirements not later than 6 months 
after the date of enactment.
    Sec. 10. Contractor Compliance. Section 10 requires the 
Secretary of Homeland Security to ensure that contract 
personnel carry out the Act's requirements.
    Sec. 11. Inspections. Section 11 requires the DHS Office of 
Inspector General to conduct unannounced inspections of CBP 
ports of entry, border patrol stations, and other detention 
facilities administered by CBP or CBP contractors and to submit 
the results and other reports related to custody operations to 
Congress. No Member of Congress may be denied access to a 
facility owned or operated by CBP.
    Sec. 12. GAO Report. Section 12 requires the Government 
Accountability Office to commence a study no later than six 
months after the date of enactment on the management and 
oversight of ports of entry, border patrol stations, and other 
CBP detention facilities, as well as the extent to which CBP 
personnel engage in abusive, profane, or harassing conduct, or 
other conduct evidencing hatred or prejudice in carrying out 
the Act, including on social media platforms, and report to 
Congress within 1 year on the results of the study.
    Sec. 13. Rule of Construction. Section 13 states that 
nothing in this Act may be construed to authorize CBP to detain 
individuals for longer than 72 hours.
    Sec. 14. Definitions. Section 14 defines the following 
terms: interpretation services; child; and U.S. Customs and 
Border Protection facility.


                            Dissenting Views

    H.R. 3239\1\ would impose burdensome--and in many cases 
impossible--standards of care onto hundreds of U.S. Customs and 
Border Protection (``CBP'') facilities across the country. As 
the men and women of CBP confront the realities of an 
unprecedented crisis, H.R. 3239 would require the provision of 
extensive medical screenings and follow-up health care at any 
CBP facility where individuals are detained or transported 
after their initial encounter with CBP. It would also impose 
certain standards with respect to facilities, nutrition, and 
sanitation. The requirements of this bill are onerous, 
applicable to hundreds of diverse facilities in both urban and 
remote regions, and would be impossible to implement within the 
6 month time-frame required by the bill.
---------------------------------------------------------------------------
    \1\Amendment in the Nature of a Substitute to H.R. 3239, as amended 
by the Lofgren Manager's Amendment, 116th Cong. (Humanitarian Standards 
for Individuals in Customs and Border Protection Custody Act).
---------------------------------------------------------------------------
    Under H.R. 3239, all aliens entering CBP custody would 
receive an extensive medical assessment\2\--essentially a full 
physical--which must take place in ``a private space that 
provides a comfortable and considerate atmosphere for the 
patient . . .''\3\ The assessment must include ``an interview 
and the use of a standardized medical intake questionnaire or 
the equivalent,'' ``screening of vital signs, including pulse 
rate, body temperature, blood pressure, oxygen saturation, and 
respiration rate,'' ``screening for blood glucose for known or 
suspected diabetics,'' ``weight assessment of detainees under 
12 years of age,'' ``a physical examination,'' and ``a risk-
assessment and the development of a plan for monitoring and 
care, when appropriate.''\4\ In addition to providing 
interpreters, CBP must also ensure ``chaperones'' are present 
during these screenings.\5\ CBP medical personnel must document 
these physicals and provide those medical records to detainees 
upon release or transfer from custody.\6\ These screenings must 
occur within 12 hours of a detainee's arrival at a CBP 
facility, but not later than 6 hours in the case of a ``high 
priority individual''.\7\
---------------------------------------------------------------------------
    \2\Id. at Sec. 2(c).
    \3\Id. at Sec. 2(i)(1).
    \4\Id. at Sec. 2(c)(1).
    \5\Id. at Sec. Sec. 2(f) and (g).
    \6\Id. at Sec. 2(h).
    \7\Id. at Sec. 2(d).
---------------------------------------------------------------------------
    In addition to the licensed medical professionals necessary 
to conduct the initial health screenings, who must be located 
on site, the bill states the following personnel ``shall be 
located on site to the extent practicable'' at each CBP 
facility: ``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 . . 
.''\8\ CBP is also required to ensure access to ``psychological 
assistance'' for individuals ``who have experienced events that 
may cause severe trauma or toxic stress . . .''\9\ Moreover, 
CBP facilities are required to have, on location, ``[a]ll 
necessary and appropriate medical equipment and facilities to 
conduct the health screenings and follow-up care required under 
[Section 2 of the bill], to treat trauma, to provide emergency 
care, including resuscitation of individuals of all ages, and 
to prevent the spread of communicable diseases.''\10\ CBP is 
also required to have ``[a]ppropriate 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.''\11\ CBP would also be required to transport 
individuals for follow-up care if they are discharged from 
another medical facility.\12\
---------------------------------------------------------------------------
    \8\Id. at Sec. 2(j).
    \9\Id. at Sec. 2(e)(3).
    \10\Id. at Sec. 2(i)(2).
    \11\Id. at Sec. 2(i)(4).
    \12\Id. at Sec. 8.
---------------------------------------------------------------------------
    During the markup, Republicans pointed out at least some 
Veterans Affairs hospitals do not have specialty physicians 
located on site, and referrals can take weeks. Thus H.R. 3239 
will ensure better care for some illegal aliens than our 
military veterans receive.
    H.R. 3239 imposes facilities requirements that would limit 
CBP's ability to respond to a surge or influx of migrants. The 
bill states, ``No detainee shall be placed in a room for any 
period of time if the detainee's placement would exceed the 
maximum occupancy level''\13\ but also limits the ability to 
use temporary outdoor facilities by requiring ``The facility 
shall be well lit and well ventilated, with the humidity and 
temperature kept at comfortable levels (between 68 and 74 
degrees Fahrenheit).''\14\ This would prevent CBP from being 
able to use shading structures or other temporary outdoor 
facilities to house migrants in times of influx.
---------------------------------------------------------------------------
    \13\Id. at Sec. 5(5).
    \14\Id. at Sec. 5(7).
---------------------------------------------------------------------------
    The bill would also require ``private'' toilets ``with not 
less than one toilet available for every 12 male detainees, and 
1 toilet for every 8 female detainees'',\15\ diaper changing 
stations,\16\ ``the opportunity to bathe daily in a permanent 
or portable shower that is private and secure,''\17\ (emphasis 
added), and access to certain personal hygiene products.\18\ 
H.R. 3239 also requires CBP to install video-monitoring at all 
covered facilities, but also requires that CBP provide 
``lighting and noise levels that are safe and conducive for 
sleeping'' between certain hours.\19\ This will require CBP to 
retrofit facilities with infrared cameras so the facilities can 
be monitored in low-light levels at night. An amendment 
accepted by the Democrats at markup will require CBP to post a 
written ``language-appropriate `Detainee Bill of Rights,' 
including indigenous languages'' in all areas where detainees 
are located which ``shall include all rights afforded to the 
detainee under this bill.''\20\
---------------------------------------------------------------------------
    \15\Id. at Sec. 3(2).
    \16\Id. at Sec. 3(3).
    \17\Id. at Sec. 3(4).
    \18\Id. at Sec. 3(5).
    \19\Id. at Sec. 5(10) and 5(12).
    \20\Amendment to H.R. 3239 offered by Ms. Jackson Lee of Texas.
---------------------------------------------------------------------------
    Under H.R. 3239, all CBP facilities where individuals are 
taken upon apprehension\21\ would have to comply with the 
requirements imposed by the bill, including U.S. Border Patrol 
Stations, ports of entry (including land, sea, and airports), 
checkpoints, forward operating bases, and secondary inspection 
areas.\22\ H.R. 3239 is a one-size-fits-all approach that won't 
work. These facilities would have to have medical staff on hand 
to conduct initial medical screenings regardless of the number 
of staff or apprehensions. It is important to note not all CBP 
facilities are Border Patrol stations or are in urban areas 
with ready access to medical specialties or emergency services. 
In fact, many are in remote areas of not just southern border 
states, but also states such as Alaska, where placement of such 
personnel would be unfeasible and a waste of funding in times 
of low border crossing numbers. CBP ``facilities'' as defined 
in the bill would include remote checkpoints, very busy 
international airports, and small port structures that are big 
enough only to fit a few people.
---------------------------------------------------------------------------
    \21\Amendment in the Nature of a Substitute to H.R. 3239, as 
amended by the Lofgren Manager's Amendment, 116th Cong. (Humanitarian 
Standards for Individuals in Customs and Border Protection Custody Act) 
at Sec. 2(i).
    \22\Id. at Sec. 14(3) (``U.S. Customs and Border Protection 
Facility'' defined).
---------------------------------------------------------------------------
    Very small ports in very remote areas that process only a 
few individuals per day would have to comply the same way that 
a port in an urban area would have to comply. CBP already has a 
difficult time competing with the private sector for their 
current staff or contracted medical professionals, and this 
bill would expand those requirements even in geographically 
remote areas.
    It is also important to note CBP may be limited in its 
ability to unilaterally make required facilities changes. For 
example, the Government Services Administration (``GSA'') would 
have to approve changes to certain CBP facilities. When such 
facilities are co-located at airports or seaports, the port 
owner's approval would also be required to approve such 
changes--which would take significant time.
    The cost of compliance with all of H.R. 3239's requirements 
is unclear but will be immense, requiring updates to hundreds 
of CBP facilities, requisition of personnel and equipment, and 
training\23\ for all CBP personnel at covered facilities. This 
bill would add to the unmet facility needs for CBP (currently 
around $3 billion), as CBP would be required to rescope or 
build on to hundreds of facilities. Also unclear is how it will 
be paid for as the bill contains no authorization for 
appropriations. Republicans offered an amendment at markup to 
require the DHS Secretary to report on the costs of 
implementation to Congress, and to delay implementation beyond 
six months\24\ if Congress has not appropriated sufficient 
funds to carry out the requirements of the bill. No Democrats 
voted for the amendment.
---------------------------------------------------------------------------
    \23\Id. at Sec. 7.
    \24\Id. at Sec. 9(b).
---------------------------------------------------------------------------
    H.R. 3239 would also make the border crisis worse by 
changing a longstanding practice that family units consist of 
parents/legal guardians and their minor children. Instead, CBP 
will now be required to consider any ``adult relative'' of a 
minor child to be part of a family unit, and the child must be 
detained with the adult relative ``unless such an arrangement 
poses safety or security concerns.''\25\ ``Adult relative'' is 
undefined. Democrats at the markup claimed it would apply only 
in the case of a sibling or grandparent, but that's not what 
the bill text actually says. Presumably an ``adult relative'' 
would include aunts and uncles, or even third cousins twice 
removed. The Flores Settlement Agreement already incentivizes 
bringing a child to the border to guarantee release into the 
U.S. interior. H.R. 3239 will expand beyond parents and legal 
guardians the adults who can now utilize this loophole, 
allowing distant relatives--or human traffickers posing as 
distant relatives--to use children to gain access to the United 
States. This requirement will also add to DHS's responsibility 
to verify a true family relationship to ensure children are not 
being trafficked, even though distant family relationships will 
be harder to verify than those of a parent or legal guardian. 
Republicans offered an amendment at markup to ensure children 
were kept together with their parents or legal guardians, and 
prevent widening this loophole. No Democrats voted for the 
amendment.
---------------------------------------------------------------------------
    \25\Id. at Sec. 5(2).
---------------------------------------------------------------------------
    There is a crisis on our southern border caused by an 
unprecedented influx of individuals. U.S. Border Patrol 
apprehended 94,897 individuals in June, 132,880 in May, 99,290 
in April, and 92,835 in March.\26\ Whereas prior influxes were 
primarily comprised of single adult males, the overwhelming 
majority of current apprehensions consist of family units and 
unaccompanied alien children. This influx has strained current 
infrastructure and overwhelmed the men and women of law 
enforcement who must respond to this crisis. Yet Democrats at 
the markup claimed the overcrowded conditions at CBP facilities 
are the result of the administration's incompetence or 
deliberate failure to plan for ``seasonal'' migration flows, 
and argued the requirements imposed by H.R. 3239 are necessary 
to prevent the U.S. Government from committing ``torture'' of 
children in custody. There is nothing ``seasonal'' about the 
current unprecedented influx of migrants overwhelming the 
system and straining current infrastructure, and the 
``torture'' claim is profoundly irresponsible, disrespectful, 
and untrue. As Democrats continue to deny the existence of a 
border crisis and accuse the Trump Administration of committing 
torture, it is unsurprising that H.R. 3239 is aimed at 
ameliorating the symptoms of the crisis instead of the root 
causes.
---------------------------------------------------------------------------
    \26\Southwest Border Migration FY 2019, U.S. Customs and Border 
Protection, U.S. Border Patrol Southwest Border Apprehensions FY 2019. 
Available at https://www.cbp.gov/newsroom/stats/sw-border-migration.
---------------------------------------------------------------------------
    Given that Democrats are content to blame the Trump 
Administration for a problem House Democrats refuse to fix, it 
is unsurprising H.R. 3239 does nothing to address the influx of 
migrants. H.R. 3239 does not address deficiencies in current 
U.S. law that act as a pull factor for families and 
unaccompanied children. It does not reform the asylum system to 
ensure legitimate claims for protection are quickly 
adjudicated, while frivolous claims are quickly denied. It does 
not solve the problems of economic insecurity, corruption, and 
criminal activity in migrants' home countries that act as push 
factors. Instead, it will simply impose unreasonable 
requirements on CBP, turning their facilities into free 
hospitals for illegal aliens, while limiting their ability to 
respond to future influxes--which the bill ensures will 
undoubtedly occur.
    I urge my colleagues to reject this bill.
            Sincerely,
                                   Doug Collins,
                                           Ranking Member.

                                  [all]