[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 4096 Introduced in Senate (IS)]

<DOC>






117th CONGRESS
  2d Session
                                S. 4096

  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

                             April 27, 2022

 Mr. Lujan (for himself, Mr. Heinrich, and Mrs. Feinstein) 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 the custody of CBP.
            (5) Forward operating base.--The term ``forward operating 
        base'' means a permanent facility established by CBP in forward 
        or remote locations, and designated by CBP.
            (6) Interpretation services.--The term ``interpretation 
        services'' includes translation services that are performed 
        either 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 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 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 travel--
                            (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) 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--
            (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 detainees have access to--
            (1) not less than 1 gallon of drinking water per person per 
        day, in addition 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 less 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, as they may decide;
            (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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