[Congressional Record Volume 165, Number 156 (Thursday, September 26, 2019)]
[House]
[Pages H8032-H8037]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
U.S. BORDER PATROL MEDICAL SCREENING STANDARDS ACT
Mr. THOMPSON of Mississippi. Mr. Speaker, pursuant to House
Resolution 577, I call up the bill (H.R. 3525) to amend the Homeland
Security Act of 2002 to direct the Commissioner of U.S. Customs and
Border Protection to establish uniform processes for medical screening
of individuals interdicted between ports of entry, and for other
purposes, and ask for its immediate consideration.
The Clerk read the title of the bill.
The SPEAKER pro tempore. Pursuant to House Resolution 577, in lieu of
the amendment in the nature of a substitute recommended by the
Committee on Homeland Security printed in the bill, an amendment in the
nature of a substitute consisting of the text of Rules Committee Print
116-33 is adopted, and the bill, as amended, is considered read.
The text of the bill, as amended, is as follows:
H.R. 3525
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled.
SECTION 1. SHORT TITLE.
This Act may be cited as the ``U.S. Border Patrol Medical
Screening Standards Act''.
SEC. 2. RESEARCH REGARDING PROVISION OF MEDICAL SCREENING OF
INDIVIDUALS INTERDICTED BY U.S. CUSTOMS AND
BORDER PROTECTION BETWEEN PORTS OF ENTRY.
(a) In General.--Not later than one year after the date of
the enactment of this Act, the Secretary of Homeland
Security, acting through the Under Secretary for Science and
Technology of the Department of Homeland Security, in
coordination with the Commissioner of U.S. Customs and Border
Protection and the Chief Medical Officer of the Department,
shall research innovative approaches to address capability
gaps regarding the provision of comprehensive medical
screening of individuals, particularly children, pregnant
women, the elderly, and other vulnerable populations,
interdicted by U.S. Customs and Border Protection between
ports of entry and issue to the Secretary recommendations for
any necessary corrective actions.
(b) Consultation.--In carrying out the research required
under subsection (a), the Under Secretary for Science and
Technology of the Department of Homeland Security shall
consult with appropriate national professional associations
with expertise and non-governmental experts in emergency,
nursing, and other medical care, including pediatric care.
(c) Report.--The Secretary of Homeland Security shall
submit to the Committee on Homeland Security of the House of
Representatives and the Committee on Homeland Security and
Governmental Affairs of the Senate a report containing the
recommendations referred to in subsection (a), together with
information relating to what actions, if any, the Secretary
plans to take in response to such recommendations.
SEC. 3. ELECTRONIC HEALTH RECORDS IMPLEMENTATION.
(a) In General.--Not later than 90 days after the date of
the enactment of this Act, the Chief Information Officer of
the Department of Homeland Security, in coordination with the
Chief Medical Officer of the Department, shall establish
within the Department an electronic health record system that
can be accessed by all departmental components operating
along the borders of the United States for individuals in the
custody of such components.
(b) Assessment.--Not later than 120 days after the
implementation of the electronic health records system, the
Chief Information Officer, in coordination with the Chief
Medical Officer, shall conduct an assessment of such system
to determine system capacity for improvement and
interoperability.
The SPEAKER pro tempore. The bill, as amended, shall be debatable for
1 hour equally divided and controlled by the chair and ranking minority
member of the Committee on Homeland Security.
The gentleman from Mississippi (Mr. Thompson) and the gentleman from
Alabama (Mr. Rogers) each will control 30 minutes.
The Chair recognizes the gentleman from Mississippi.
General Leave
Mr. THOMPSON of Mississippi. Mr. Speaker, I ask unanimous consent
that all Members may have 5 legislative days to revise and extend their
remarks and to include extraneous material on this measure.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Mississippi?
There was no objection.
Mr. THOMPSON of Mississippi. Mr. Speaker, I yield myself such time as
I may consume.
Mr. Speaker, H.R. 3525, the U.S. Border Patrol Medical Screening
Standards Act, as amended, seeks to build on legislation passed by the
House in July to strengthen the medical care and attention provided to
migrants who cross our borders.
In July, in response to reports of inhumane conditions at our
southern border and the death of six children who had been in CBP
custody, the House approved a bill to require in-person medical
screening by licensed medical professionals for apprehended
individuals.
H.R. 3525 builds upon that measure by focusing on improving health
screening processes and recordkeeping within DHS. The bill authored by
the gentlewoman from Illinois (Ms. Underwood) takes a two-pronged
approach.
First, it requires DHS to research innovative solutions for
deficiencies in the medical screening it conducts at the border. This
research is to be carried out in consultation with national medical
professional associations that have expertise in emergency medicine,
nursing, and pediatric care.
Importantly, in carrying out the research, DHS is directed to pay
particular attention to the screening of children, pregnant women, the
elderly, and other vulnerable populations.
Once completed, DHS is required to transmit to Congress information
on what actions the Department plans to take in response to the
research findings.
{time} 1515
The second prong of H.R. 3525 is focused on driving DHS to improve
interoperability among components responsible for the care of
apprehended individuals. It does so by requiring DHS to set up an
electronic health records system to track health screening and care of
individuals in DHS custody. This system would create records that could
be accessed by all the relevant DHS components.
The benefits of such a system are unmistakable:
A migrant's medical information cannot get lost.
There will be a clear system to track when any followup medication or
medical attention is needed, ensuring cases will not fall through the
cracks.
It will also avoid duplication of medical services and time delays
due to lost or incomplete medical records.
As important, all the information gained from the initial medical
screening will follow the children and adults as they are transferred
to other DHS components.
Even though apprehension numbers have recently declined, we must take
the lessons learned from the poor handling of the recent migrant crisis
to heart and drive performance improvement within DHS.
H.R. 3525 represents a step in the right direction, and, as such, I
urge my colleagues to support the legislation.
Mr. Speaker, I reserve the balance of my time.
Mr. ROGERS of Alabama. Mr. Speaker, I yield myself such time as I may
consume.
Mr. Speaker, here we go again. Yesterday, the majority passed a
partisan messaging bill to provide illegal immigrants with an
additional complaint line at the Department of Homeland Security. It
has no chance of becoming law. Today, they are back at it with
[[Page H8033]]
another partisan messaging bill that will never become law. This time,
it is a bill to provide illegal immigrants with electronic health
records.
This bill before us today requires the Department of Homeland
Security to set up an interoperable electronic health records system to
track the medical history of millions of illegal immigrants. The bill
requires the system to be up and running in 90 days.
Implementing an electronic health records system is a complicated,
labor-intensive undertaking. They begin with a configuration process to
tailor the commercial software to a client's needs and then proceed to
a site-by-site installation process, followed by workforce training.
It typically takes a year or more to get new electronic health
records up and running at a hospital with just one location. Making
these systems interoperable across government agencies only creates
more complexity, extending implementation by years.
If you need a real-world example of just how unachievable this is,
look no further than the Coast Guard. The Coast Guard spent 7 years
trying to get an interoperable health records system in place for its
50,000 employees. But, after all that time, the system didn't work.
Coast Guard servicemembers are still forced to rely on paper medical
records.
The Coast Guard is not alone. The Department of Defense and the
Veterans Administration won't have fully interoperable health records
systems in place for another 5 to 9 years, respectively.
H.R. 3525 also requires DHS to research innovative ways to conduct
medical screenings on illegal immigrants. DHS already conducts
thousands of medical screenings on migrants on a daily basis. Finding
new ways to deliver health screenings more effectively could save time
and money, but researching innovations in healthcare delivery is not
the mission of DHS.
The research mandated by this bill is the responsibility of the
Department of Health and Human Services. DHS research is properly
focused on preventing drugs, criminals, and terrorists from entering
our borders. We should not force DHS to lose its focus on these
critical Homeland Security priorities.
Finally, the bill before us today fails to provide DHS with any
funding to achieve the illegal immigrant medical screening research and
interoperable health records mandates. We have no idea how much this
bill will cost because the majority failed to file a cost estimate from
CBO.
However, we do know from the experience of the VA, DOD, and Coast
Guard that interoperable electronic health records systems are
extremely expensive undertakings. The DOD and VA are on track to spend
over $25 billion on their systems. The Coast Guard's failed system to
track just 50,000 people cost $67 million.
Using the Coast Guard as a baseline, it would cost over $2.5 billion
to track the medical history of just the illegal immigrants that have
come into our country over the last 2 years. In other words, without
any funding provided for the mandates in this bill, billions in
critical DHS funding used to counter terrorist plots, equip first
responders, and respond to natural disasters would be diverted to pay
for a benefit for millions of illegal migrants.
Mr. Speaker, what is truly disappointing about this bill that we have
considered over the last 2 days is that they did nothing to prevent
another humanitarian crisis at our border. We should be working
together on legislation that reforms our broken immigration system,
protects vulnerable families and children from human smugglers, reduces
the asylum backlog, and expands migrant processing and long-term
housing.
When this partisan messaging bill fails to move in the Senate, I hope
Democrats will finally choose policy over politics and agree to work
with Republicans on solutions to our border security problems.
Mr. Speaker, I reserve the balance of my time.
Mr. THOMPSON of Mississippi. Mr. Speaker, I yield 6 minutes to the
gentlewoman from Illinois (Ms. Underwood), sponsor of this legislation.
Ms. UNDERWOOD. Mr. Speaker, I introduced the U.S. Border Patrol
Medical Screening Standards Act in response to the conditions I
witnessed firsthand on our border this year: first in April, then in
July, and then again in August.
The humanitarian crisis at our border is a problem that we should be
working together to solve with an evidence-based approach. This
legislation is evidence-based, and I am incredibly proud that it was
able to be forwarded by the Committee on Homeland Security with a voice
vote.
I also appreciated Ranking Member Rogers' willingness to engage with
us on this bill, and I am committed to continuing to look for ways to
work together on these issues going forward.
As introduced, my bill had three sections, two of which are included
in the legislation we are debating today.
First, my bill ensures implementation of an integrated electronic
health records system, or EHR, to be used by those caring for migrants
at the border. This is a direct ask from medical officers at the
Department of Homeland Security who have identified it as a high-
priority barrier to providing care.
We know that migrants may be transferred between different sites and
components multiple times while in custody, and an interoperable EHR is
essential to their health records remaining accessible.
Immigration and Customs Enforcement has an EHR. The Office of Refugee
Resettlement has an EHR. But Customs and Border Protection, which
includes the U.S. Border Patrol, doesn't.
When I was at the border, I saw busy, overworked Border Patrol
officials having to keep health records on paper. I also saw how these
records don't always follow migrants between facilities and transfers
of custody.
As DHS works to improve its medical screening of children and
migrants at the border to ensure there is a minimum standard of care,
the need for proper recordkeeping on those screenings will only
increase.
Furthermore, children can spend days or weeks in CBP custody before
being transferred to another component. There must be a transferrable
record of the medical care those kids receive and the medical
conditions that they report. That is why DHS has already begun
independently taking steps toward an electronic health records system,
hiring staff, and soliciting individual component requirements.
This legislation formalizes and directs that process, setting an
aggressive but achievable timeline that reflects the urgency of the
humanitarian situation at our southern border.
Second, this bill directs DHS to research innovative approaches to
address any capability gaps in providing medical screening,
particularly for children, pregnant women, the elderly, and other
vulnerable populations.
As a nurse, I believe in data-driven, evidence-based policymaking.
Data shows that, in recent years, the migrant population arriving at
our southern border has shifted from primarily adult, economic migrants
to a large number of families and unaccompanied children seeking
asylum.
DHS must be better prepared to respond to these shifts, and barriers
to providing basic medical care to migrants in U.S. custody will
persist as our country continues its national conversation around
immigration policy. The research required by this litigation will
ensure that we have robust data on DHS' capabilities in order to inform
our response.
My bill also ensures that, in conducting this research, DHS
collaborates with medical professionals who have expertise in pediatric
care so that DHS is addressing both the physical and the mental health
needs of migrant children at the border. By proactively focusing on
children, this research is intended to prevent the care gaps we have
seen in other Federal facilities caring for migrant children.
Lastly, I am proud that the third section of this bill, as
introduced, was incorporated into my colleague Dr. Ruiz' legislation
that was passed by the House in July. This section set consistent
minimum standards for medical screening of migrants at the border.
Proactive, consistent, and timely medical screening is essential to a
public health response to the humanitarian crisis on our border, but
effective medical protocols are not in practice right now.
[[Page H8034]]
By training border personnel in medical screening, the legislation
provides law enforcement and staff at the border the support that they
need so that they aren't being forced to deal with medical situations
that we haven't equipped them for. That is why I am pleased that this
screening language passed the House in July.
In addition to these medical screening standards, we need to ensure
DHS has an electronic health record and close those research gaps. That
is what this legislation on the floor right now would do: build on the
legislation we passed in July and implement the remaining two
components of the U.S. Border Patrol Medical Screening Standards Act.
Anyone who has been to the border, including many of my colleagues on
the Committee on Homeland Security, has seen how overwhelming the
humanitarian situation there is. This committee and this Congress have
consistently been willing to provide the Department of Homeland
Security with the resources it needs, but with those resources comes
accountability and oversight. This legislation is an important and a
sensible step forward to make sure that both migrants and border
officials are not placed in situations that are unsafe.
Mr. Speaker, in closing, I want to recognize and thank Chairman
Thompson and his staff on the Committee on Homeland Security--including
Rosaline Cohen, Alexandra Carnes, Wendy Clerinx, Ethan McClelland, and
Brittany Lynch--for their months of hard work on this legislation, and
I urge my colleagues on both sides of the aisle to support it.
Mr. ROGERS of Alabama. Mr. Speaker, I am curious about the
announcement that the administration is in support of this and is
working toward this, because they have already issued an announcement
that they oppose this piece of legislation. So, if it did pass, it
would be vetoed by the President.
Mr. Speaker, I yield 3 minutes to the gentleman from Pennsylvania
(Mr. Joyce), an outstanding member of the Committee on Homeland
Security.
Mr. JOYCE of Pennsylvania. Mr. Speaker, I rise today in opposition to
H.R. 3525.
Yet again, I fear that this partisan legislation is a missed
opportunity to seriously address the humanitarian and security crisis
that exists today on our southern border.
All of us here today can agree that every human being is worthy of
dignity and respect.
As a physician, I understand the importance of efficient and
compassionate healthcare. At the same time, I understand firsthand how
difficult it would be to achieve the requirements that are outlined in
this bill.
Establishing an electronic health records system in any medical
system takes at least a year, in the best case scenario. In the
bureaucratic web of the Federal Government, this tedious task becomes
nearly impossible.
For years, Members of this House have been working to help the
Department of Veterans Affairs implement its electronic health records
system, yet the VA won't have this completed for another 9 years.
Quite frankly, requiring the Department of Homeland Security to
implement an interoperable electronic health records system for illegal
immigrants in 90 days--it is simply unrealistic.
Adding to the problem, this costly project would distract from other
pressing needs on the border. Our Customs and Border Protection law
enforcement agents are hardworking Americans who have been tasked with
an incredibly difficult job.
{time} 1530
While protecting our country on the southern border, they are also
providing humanitarian aid to an unprecedented number of immigrants.
They need our help. They do not need Congress to add unnecessary and
unachievable burdens to their duties.
It is disappointing, but it is not surprising that House Democrats
have chosen this approach. Time and time again, we return to the floor
to debate partisan bills that will do nothing to address the underlying
cause of this crisis.
Rather than continuing to grandstand on the House floor, I encourage
my colleagues to, once again, return to the Committee on Homeland
Security to work on solutions that will secure the border, end asylum
loopholes, and protect our country.
Mr. THOMPSON of Mississippi. Mr. Speaker, I yield 2 minutes to the
gentlewoman from California (Ms. Roybal-Allard), the chairwoman of the
House Appropriations Subcommittee on Homeland Security.
Ms. ROYBAL-ALLARD. Mr. Speaker, I rise in strong support of H.R.
3525, and I commend my colleague, Lauren Underwood, for introducing
this important legislation.
When migrants are in U.S. Federal custody, it is our moral
responsibility to ensure they are treated humanely and receive
appropriate medical screenings and care.
Earlier this year, the House Appropriations Subcommittee on Homeland
Security, which I chair, appropriated significant additional resources
to CBP to improve medical care and screening.
H.R. 3525 will help ensure this care is standardized across the
Border Patrol by requiring it to formalize the medical screening
process and to come up with innovative approaches to fill medical
screening gaps.
The bill also requires the Border Patrol to have a singular
electronic health record system, accessible to other DHS components, to
ensure continuance of care for migrants.
These are smart, simple steps that can save the lives of migrants who
left tragic situations in their home country to seek refuge in the
United States. I strongly urge my colleagues to vote in favor of this
bill.
Mr. ROGERS of Alabama. Mr. Speaker, I yield 3 minutes to the
gentleman from Indiana (Mr. Banks), an outstanding leader in the
Republican Conference.
Mr. BANKS. Mr. Speaker, I thank the ranking member for yielding.
I oppose H.R. 3525 because it is poorly conceived, erroneously
drafted, and extremely risky.
This bill would require the Border Patrol to divert resources from
its core mission of protecting our Nation's borders and create a new
medical screening system for those who illegally cross and enter the
country between ports of entry. I believe every part of that is
wrongheaded.
However, even if you agree with the policy, this is not the way to do
it. Handing DHS and CBP a 30-day mandate to put an electronic health
records system in place has no basis in reality.
VA is currently in the second year of a 10-year, $16 billion EHR
overhaul. I spend much of my time in Congress overseeing it on the
Veterans' Affairs Committee.
The EHR implementation is a tall order for the VA, which has tens of
thousands of doctors and nurses, a huge health IT budget, and
healthcare as its core mission.
The DHS Chief Information Officer and CBP have none of those things.
All available evidence indicates giving them that mandate is deeply
unwise.
There is no score or cost estimate whatsoever. The score that was
filed is from the Enhanced Border Security and Visa Entry Reform Act of
2002, which is completely unrelated.
We are being asked to vote on this legislation blindly. Based on the
experience of institutions similar in size to CBP that have implemented
EHRs, the price tag could easily run into the billions. Five to 10
years is a realistic timeline, not 30 days.
Altogether, I think this is a mistake, even if well-intentioned.
We should be devoting our resources to reducing border crossings
between ports of entry. We should prioritize getting detainees out of
Border Patrol custody and into ICE and HHS custody, which already have
mandates and capabilities to provide medical care.
I strongly oppose H.R. 3525 for these reasons, and I strongly urge my
colleagues to vote ``no.''
Mr. THOMPSON of Mississippi. Mr. Speaker, I yield 3 minutes to the
gentlewoman from New York (Miss Rice), the chair of the Homeland
Security, Border Security, Facilitation, and Operations Subcommittee.
Miss RICE of New York. Mr. Speaker, six children have died in DHS
custody over the past year.
On Christmas Day in 2018, 8-year old Felipe Alonzo Gomez died in the
custody of U.S. Customs and Border Protection. He was the second child
that month to die in CBP custody. And after
[[Page H8035]]
his death, CBP implemented a new medical screening process for young
children in their care.
However, as we soon learned, this process was not adequate, because
four more children died in CBP custody from preventable illnesses and
substandard living conditions.
Even after these new screening processes were put in place, both CBP
personnel and their facilities along the southern border remained
completely ill-equipped for months. That is why this past July, the
House passed H.R. 3239, the Humanitarian Standards for Individuals in
Customs and Border Protection Custody Act.
This bill would require DHS to improve screening processes and
utilize professional medical staff. And it allocated other necessary
resources to conduct effective initial medical screenings for all
people in CBP custody.
Today, I am proud to support Congresswoman Underwood's effort to
build on that legislation.
I was honored that, in her first few months in office, Congresswoman
Underwood joined me on two separate trips to the southern border. She
drafted this bill as a direct result of what she witnessed on those
trips.
H.R. 3525 directs DHS to consult with medical experts to improve its
medical screening process and to finally establish an electronic health
record system for people in CBP custody.
DHS has always been on the cutting edge of innovation, leveraging the
latest in technological advances to fulfill its critical mission of
protecting our homeland. And I believe it is now vital that DHS use
that same approach when caring for the individuals and families in its
custody.
The Department has a long, successful history of working with the
private sector to achieve its counterterrorism, emergency response, and
cybersecurity goals.
This bill would require DHS to consult with national and medical
professional associations who have the expertise in emergency medicine,
nursing, pediatric care, and other relevant medical skills to make sure
that DHS is providing appropriate medical care to migrants in its
custody.
It specifically instructs DHS to research innovative approaches for
screening vulnerable populations, including pregnant women, the
elderly, and people with disabilities.
CBP is long overdue for an electronic health records system. In 2019,
there is no good reason why an agency under as much strain as CBP is
still using paper records. An electronic health record system would
improve CBP's internal operations and expedite coordination when
children and adults are transferred to other agencies.
I would hope that my colleagues on the other side of the aisle agree
that not one more child should die in the custody of the Federal
Government.
This bill should not be controversial. It is bipartisan; it offers
commonsense solutions; and it will help save lives.
I strongly urge my colleagues to join me in supporting H.R. 3525
today.
Mr. ROGERS of Alabama. Mr. Speaker, I yield such time as he may
consume to the gentleman from Tennessee (Mr. David P. Roe), the ranking
member of the Veterans' Affairs Committee, and a physician.
Mr. DAVID P. ROE of Tennessee. Mr. Speaker, I rise today in
opposition to H.R. 3525, the U.S. Border Patrol Medical Screening
Standards Act.
Before coming to Congress, I was a practicing physician for over 31
years. I also served in the 2nd Infantry Division in Korea in the 2nd
Medical Battalion where, at that time, we trained, we spent a lot of
time in the field training for mass casualties and big events.
I went to the border; I spent four days down there on two separate
occasions. The last time was in June of this year, with the Medical
Director of the Department of Homeland Security, as chief medical
adviser, and five other members of the Doctors Caucus at the McAllen,
Texas, Rio Grande Valley sector to see for myself what was going on.
At that time, Mr. Speaker, there were 1,000 to 1,500 or more people a
day who came across. As we stood there by the Rio Grande River, 15
people walked up and turned themselves in while we weren't there more
than 15 or 20 minutes.
And we looked at the facilities they had; about how they tried to
screen those folks; and then how they tried to sort them afterwards.
And, Congress, it was a shame on us for not providing ICE more beds so
you could move those folks off of the border more quickly.
With these folks, they have made--many of them have made long and
terrible journeys to get to where they are.
There is some good news, and I want to share this with you now. We
just had a meeting today that the ranking member on the committee was
there with the Acting Director of Homeland Security; and daily arrivals
are now down 64 percent. Attainee numbers are way down, from 20,000 in
custody at the border, to an average of 3,500 to 4,500 per day. And the
best news, I think, are unaccompanied children have been reduced from
over 2,700 to fewer than 150.
So there have been great improvements, which will actually improve
the health outcomes when you have time enough to go through and screen
those folks.
Can you imagine in a facility that is set for 1,000 people, and you
have 1,500 or 1,800 people, you have nowhere to send them, and a flu
epidemic breaks out? It is a very difficult thing to deal with.
So the folks at Customs and Border Patrol I think were doing a
yeoman's job based on the situation they were put in.
The problem we face isn't the lack of adequate care or screening. It
is due to the previously lax enforcement of our immigration laws, and
our Border Patrol agents just really being overrun with people
illegally crossing the border.
Really, without adding new and impossible-to-meet guidelines for our
Border Patrol agents, we should look for other ways to intervene with
illegal crossings, and I have mentioned that.
These people are often, as I said, escaping unimaginable problems in
their home country. But once they reach our border, the CBP is doing
the absolute best they can to help them.
Now, the bill would accomplish very little but overburdening our
already-taxed DHS staff with their limited resources. This bill would
require the DHS to purchase and implement an electronic health record
within 30 days in order to coordinate care for illegal border crossers.
Mr. Speaker, I think I may be one of the only people in the U.S.
Congress that has actually implemented an electronic health record in
my own practice. It took us a year to do it in our medical practice, to
put 80,000 charts in.
Can you imagine putting over a million? And the U.S. military, the
Department of Defense, right now is spending about $5-plus-billion for
a million and a half soldiers.
The Veterans' Affairs Committee, which I am very aware of, and I will
be going to Seattle, Washington, Madigan Army Medical Center on Sunday
night and Monday of next week to evaluate their system. We are spending
$16 billion to implement this.
Let me say this: The DOD and VA spent a billion dollars trying to
implement a system where the electronic health record at DOD and VA
could talk to each other, and they failed. So it is a very difficult,
complex situation to put an electronic health record in.
I think it is a noble goal, and it should be looked at. But it is
just something not doable in 30 days. I absolutely guarantee you it
will fail. These are labor-intensive, and many of them fail.
I know, as I was saying a little bit ago, that the Department of
Defense and VA are currently implementing this program which will--the
total cost of that will be $25 billion.
And this legislation gives DHS a colossal, unfunded mandate and it
has no expertise or capacity to handle this, and would consume all of
the supplemental that we have sent them.
Further, implementing a new health record at a hospital takes a year
or more, not 30 days. So it is absolute folly to think that DHS could
do this, contract it, figure it out, train the people at all these
ports of entry, and do that in 30 days. It can't be done.
The Coast Guard, a DHS component, had a disastrous experience trying
to implement an EHR in about 40 clinics between 2010 and 2015, and they
spent $67 million and gave up.
So if we can't deliver a modern healthcare record system to our men
and women who put their lives on the line without spending billions of
dollars and the better part of a decade,
[[Page H8036]]
why would we rush to develop one that is doomed to failure for people
who are knowingly breaking our laws?
Until the VA and DOD have secured a fully interoperable record for
our servicemembers, we should not divert scarce resources and time
creating one for illegal immigrants.
I do want to say that I am willing to work with the other side in any
way, in all ways, to improve the health care of the people who come
here. We are Americans. That is what we do, and we are the best in the
world at it.
So if you want to sit down and work out an issue and a problem with
me, I am more than happy to do that.
{time} 1545
Mr. THOMPSON of Mississippi. Mr. Speaker, I yield 3 minutes to the
gentlewoman from Texas (Ms. Jackson Lee).
(Ms. JACKSON LEE asked and was given permission to revise and extend
her remarks.)
Ms. JACKSON LEE. Mr. Speaker, thank you very much for the leadership
of the chairman, and I appreciate the ranking member on the floor.
I have had the privilege of traveling with Congresswoman Underwood to
the border in some very challenging circumstances, and I appreciated,
as a nurse, as a trained nurse, as she is a trained nurse, I
appreciated the astuteness with which she viewed this matter.
Let me say to my good friend, the doctor, we are always looking
forward to trying to work with our colleagues on the basic humanity of
every person, recognizing that this is not about healthcare for
undocumented immigrants. It is about individuals who are in the custody
of the United States.
Just picture for a moment, having gone to the border now for almost
two decades as a resident of Texas, just imagine that there are moments
when there is an influx of individuals fleeing for their lives. It
happened under President Obama's administration in 2014, and we managed
it. There was no hysteria. There were facilities that were built. There
was medical care that we were able to access.
In this instance, it did not happen. And the glaring reality of
children who died and those who were working hard, the law enforcement
personnel, I saw them trying to do as much as they could, but without a
structure, we lost lives. So the importance of this legislation is
particularly one that I think is important.
Picture for a moment, when we were in the midst of the crisis, Coast
Guard medical personnel, doctors with a table, some medicine on the
corner, their medical paraphernalia out in the open where files were,
no place to deal with the medical needs of anyone. That is not
American.
We are not asking to provide healthcare. This is not Medicare or
Medicaid. It is a basic dignity of protecting the American people by
ensuring that these people are treated for whatever might be necessary.
So the e-record process is powerful because it allows the accessing
of medical care by having a record system and also by having that
system being accessed by all DHS components operating on the border. It
is just a simple case of protecting those of us in the United States,
protecting those who are in our custody.
Why not? Why not be proactive and positive for dealing with fellow
human beings?
Let's get away from this undocumented and realize this is a land of
laws and immigrants. We all, collectively, together, want to abide by
that.
But we also realize that, when 9-month-old Roger is in my hands, and
he crossed the border in the arms of his sister, that 9-month-old
Roger, even though I saw him in one of the HHS centers, probably needed
care.
Or the woman who had given birth 45 days earlier and holding in her
hands a 45-day-old baby who had not seen a doctor, she had not been to
the hospital. This might help give aid to those individuals.
So let me be very clear: This is an important initiative. It is an
initiative that I think most Americans will support.
I rise to support the gentlewoman's legislation and thank her for her
courage and astuteness in bringing this to our attention.
Mr. THOMPSON of Mississippi. Mr. Speaker, how much time do I have
remaining?
The SPEAKER pro tempore. The gentleman has 13 minutes remaining.
Mr. THOMPSON of Mississippi. Mr. Speaker, I yield 4 minutes to the
gentlewoman from California (Ms. Barragan).
Ms. BARRAGAN. Mr. Speaker, I rise today in support of H.R. 3525, the
U.S. Border Patrol Medical Screening Standards Act.
Mr. Speaker, I have been to the southern border a number of times. I
have seen the cold concrete holding cell where Felipe Gomez Alonzo, an
8-year-old boy, spent his last days. He was apprehended on December 18,
2018, and did not receive proper medical testing, screenings, and care.
Six days later, on Christmas Eve, while Americans were celebrating
family and a holiday, Felipe would go on to suffer from a 103-degree
fever. Felipe would also start vomiting and become weak, then die while
in custody of the U.S. Government.
I wish I could say that he was the last child that died in U.S.
custody, but he wasn't. In the 17 months since the Trump administration
implemented their zero-tolerance policy at the southern border,
inhumanely jailing migrant children and cruelly separating children
from their parents, six--let me repeat that, six--migrant children have
tragically fallen ill and died in Federal custody:
Darlyn Cristabel Cordova-Valle was 10 years old;
Jakelin Caal Maquin was 7;
Felipe Gomez Alonzo was 8;
Juan de Leon Gutierrez was 16;
Carlos Hernandez Vasquez was 16; and
Wilmer Josue Ramirez Vasquez was a 2\1/2\-year-old baby.
The death of these children demonstrates the dangers faced by
migrants at the hands of the very government they hoped would save
them. The inadequate medical recordkeeping is dangerous and is a huge
gap that we must fix.
How many more kids will have to die before DHS makes effective
changes in the way they improve medical screenings and track medical
records? How many?
Ms. Underwood, a nurse and the author of the bill, has been to the
southern border with me to see the problem firsthand. It is her medical
training and background that led to this bill so that we could research
ways to improve medical screenings and improve the tracking of medical
records, something that is not happening right now.
Mr. Speaker, this body and this Nation has a moral obligation to make
sure that no more children needlessly die in detention at our southern
border and, in doing so, to perhaps bring some measure of meaning to
the tragic deaths of those six children.
I urge my colleagues to support H.R. 3525.
Mr. ROGERS of Alabama. Mr. Speaker, I note several Members across the
aisle have talked about the need to improve our health screenings. This
bill does nothing to deal with that. It is about requiring the
installation of electronic medical records.
I reserve the balance of my time.
Mr. THOMPSON of Mississippi. Mr. Speaker, I yield 2 minutes to the
gentlewoman from New Jersey (Mrs. Watson Coleman).
Mrs. WATSON COLEMAN. Mr. Speaker, I want to thank the chairman for
yielding, and I want to thank my colleague, Ms. Underwood, for her work
on this very important issue.
For nearly a year now, we have watched with growing horror and
outrage as the cruel and inhumane combination of xenophobia, malicious
policy from the White House, and indifference to people in need has
built into a crisis at our southern border.
We have let this come to a point where children have died, children
fleeing violence and persecution and horrors in their home countries
seeking to come here, the land of opportunity and promise, children we
separated from their parents and loved ones, children that we failed
entirely here on our soil and in our custody.
We cannot allow that to continue, and this measure that we are taking
up today will take important steps to address gaps in medical screening
at the border so that we don't fail any more children. It pushes us to
find new ways to handle the unique needs of health screening at the
border, with special emphasis on children and vulnerable groups.
[[Page H8037]]
Just as importantly, it mandates implementation of an e-record system
so that we are not letting anyone slip through the cracks.
An e-record system is not something we have never heard of before.
What has happened at the border thus far, including the tragic deaths
of the children, those mentioned by my colleague like Jakelin Caal
Maquin and Felipe Gomez Alonzo, is proof that we are not doing enough,
and that is not because we can't.
I am grateful to Ms. Underwood for stepping up to ensure we do more,
and I urge all of my colleagues to support this important bill and its
passage.
Mr. ROGERS of Alabama. Mr. Speaker, here we have another bill that
demonstrates just how disingenuous Democrats are about securing our
borders and fixing our broken immigration system. But in a new twist,
today's bill shockingly prioritizes illegal immigrants over
servicemembers and veterans. They are going to send another partisan
messaging bill to the Senate, where it will promptly die.
When Democrats are ready to legislate real solutions to the problem
that this country faces, Republicans stand ready to work with them. In
the meantime, I urge all Members to oppose this bill.
Mr. Speaker, I yield back the balance of my time.
Mr. THOMPSON of Mississippi. Mr. Speaker, I yield myself the balance
of my time.
Mr. Speaker, in the last year, six children have died after being in
CBP custody. This disheartening statistic demands our attention,
especially when you stop to think that, in the entire decade preceding
these deaths, not one child died in CBP custody.
Processes for the treatment of migrants crossing the border clearly
need to be improved. H.R. 3525 does that by forcing DHS to look at its
medical screening process and come up with ways to improve it and
address any performance gaps. It also helps move the Department's
recordkeeping into the 21st century.
H.R. 3525 is one step we can take to ensure that the money that DHS
is already spending on screening and caring for apprehended families
and children is done wisely.
And I might add, Mr. Speaker, all of us saw the conditions that
children were kept in along the border. You can't put children in
fences. You can't give people inadequate healthcare. You can't do those
things.
Most of us in this body are either parents or grandparents or we have
relatives who are. For us not to care about children is something that
America should never be proud of. We are a nation of values. Our values
have to say that children matter.
Ms. Underwood's bill clearly says that children in the custody of the
United States Government matter. Not only do they matter, but we have
to keep up with them; we should not lose them. If they are sick, we
need to have copies of their records accessible so that our
professionals who are tasked with the responsibility of taking care of
them actually know what is going on.
So I am clear about the bill. If my colleagues on the other side are
not interested in helping children and solving this problem that we
have along our borders, then that is too bad. Democrats are prepared to
work with them if they want to. If not, children do matter.
Mr. Speaker, I urge my colleagues to support H.R. 3525, and I yield
back the balance of my time.
The SPEAKER pro tempore. All time for debate has expired.
Pursuant to House Resolution 577, the previous question is ordered on
the bill, as amended.
The SPEAKER pro tempore. The question is on the engrossment and third
reading of the bill.
The bill was ordered to be engrossed and read a third time, and was
read the third time.
The SPEAKER pro tempore. Pursuant to clause 1(c) of rule XIX, further
consideration of H.R. 3525 is postponed.
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