[House Report 116-211]
[From the U.S. Government Publishing Office]
116th Congress } { Report
HOUSE OF REPRESENTATIVES
1st Session } { 116-211
======================================================================
U.S. BORDER PATROL MEDICAL SCREENING STANDARDS ACT
_______
September 18, 2019.--Committed to the Committee of the Whole House on
the State of the Union and ordered to be printed
_______
Mr. Thompson of Mississippi, from the Committee on Homeland Security,
submitted the following
R E P O R T
together with
MINORITY VIEWS
[To accompany H.R. 3525]
[Including cost estimate of the Congressional Budget Office]
The Committee on Homeland Security, to whom was referred
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, having considered the same, report favorably
thereon with an amendment and recommend that the bill as
amended do pass.
CONTENTS
Page
Purpose and Summary.............................................. 3
Background and Need for Legislation.............................. 4
Hearings......................................................... 4
Committee Consideration.......................................... 5
Committee Votes.................................................. 6
Committee Oversight Findings..................................... 7
New Budget Authority, Entitlement Authority, and Tax Expenditures 7
Congressional Budget Office Estimate............................. 7
Statement of General Performance Goals and Objectives............ 8
Duplicative Federal Programs..................................... 8
Congressional Earmarks, Limited Tax Benefits, and Limited Tariff
Benefits....................................................... 8
Federal Mandates Statement.......................................
Preemption Clarification.........................................
Disclosure of Directed Rule Makings..............................
Advisory Committee Statement.....................................
Applicability to Legislative Branch..............................
Section-by-Section Analysis of the Legislation................... 8
Changes in Existing Law Made by the Bill, as Reported............ 9
Minority Views................................................... 12
The amendment is as follows:
Strike all after the enacting clause and insert the
following:
SECTION 1. SHORT TITLE.
This Act may be cited as the ``U.S. Border Patrol Medical Screening
Standards Act''.
SEC. 2. UNIFORM PROCESSES FOR MEDICAL SCREENING OF INDIVIDUALS
INTERDICTED BETWEEN PORTS OF ENTRY.
(a) In General.--Subtitle C of title IV of the Homeland Security Act
of 2002 (6 U.S.C. 231) is amended by adding at the end the following
new section:
``SEC. 437. MEDICAL SCREENING OF INDIVIDUALS INTERDICTED BETWEEN PORTS
OF ENTRY.
``(a) In General.--To improve border security and the processing of
individuals and families interdicted by the U.S. Border Patrol between
ports of entry, the Commissioner of U.S. Customs and Border Protection,
in coordination with the Chief Medical Officer of the Department,
shall, not later than 30 days after the date of the enactment of this
section, establish uniform processes and training to ensure consistent
and efficient medical screening of all individuals, with priority given
to children who have not yet attained the age of 18, so interdicted
before transfer from U.S. Customs and Border Protection custody, but in
no case longer than 12 hours after such interdiction, or 6 hours in the
case of a high priority individual. Such screening should be conducted
by a medical professional and should be developed in collaboration with
non-governmental experts in the delivery of health care in humanitarian
crises and in the delivery of health care to children.
``(b) Screening Process Components.--At a minimum, the uniform
processes and training established under subsection (a) shall include
the following:
``(1) Requirements for initial in-person screening that
includes documentation of the following:
``(A) Visual assessment of overall physical and
behavioral state, including any possible disability.
``(B) A brief medical history, including demographic
information, current medications (including a list of
confiscated medications and whether such have been
replaced), and any chronic or past illnesses.
``(C) Any current medical complaints.
``(D) A physical examination that includes the
screening of vital signs such as body temperature,
pulse rate, and blood pressure.
``(2) Criteria for determining when to make a referral to
higher medical care and a process to execute such referral.
``(3) Recordkeeping requirements regarding how information is
to be recorded for each initial screening under paragraph (1),
including information on the use of interpretation services.
``(4) Review by a medical professional of any prescribed
medication that is in the detainee's possession or that was
confiscated upon arrival to determine if such medication may be
kept by such detainee for use during detention, properly stored
with appropriate access for use during detention, or maintained
with a detainee's personal property.
``(5) Chaperones for the physical examination of minors,
including, as appropriate, the parent, legal guardian, or the
such minors' closest present adult relative, or a U.S. Border
Patrol agent of the same gender.
``(c) Pediatric Expertise.--A pediatric medical expert shall be on
site in every U.S. Border Patrol sector, including at U.S. Border
Patrol processing centers and at U.S. Border Patrol facilities at which
20 percent or more of detained individuals over the immediately
preceding six month period are minors. The Chief of the U.S. Border
Patrol shall prepare a plan to deploy in-person or technology-
facilitated medical consultation with a licensed medical professional
to U.S. Border Patrol facilities that experience an increase in
apprehensions of children greater than 10 percent over the preceding 60
days.
``(d) Definition.--In this section, the term `high priority
individual' means an individual who self-identifies as having a medical
condition needing prompt attention, exhibits signs of acute illness, is
pregnant, is a child, or is elderly.
``(e) Training.--Not later than 60 days after the issuance of the
uniform processes and training established under subsection (a), the
Commissioner of U.S. Customs and Border Protection shall ensure that
any individual carrying out medical screening under this section at a
U.S. Customs and Border Protection facility of individuals interdicted
by the U.S. Border Patrol between ports of entry shall complete
training on such uniform processes.''.
(b) Rule of Construction.--Nothing in this section or the amendment
made by this section may be construed as authorizing U.S. Customs and
Border Protection to detain individuals for longer than 72 hours.
(c) Clerical Amendment.--The table of contents in section 1(b) of the
Homeland Security Act of 2002 is amended by inserting after the item
relating to section 436 the following new item:
``Sec. 437. Medical screening of individuals interdicted between ports
of entry.''.
SEC. 3. 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. 4. ELECTRONIC HEALTH RECORDS IMPLEMENTATION.
(a) In General.--Not later than 30 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.
Purpose and Summary
H.R. 3525, the ``U.S. Border Patrol Medical Screening
Standards Act,'' improves on existing medical screenings
performed by U.S. Border Patrol. The bill requires U.S. Customs
and Border Protection (CBP), in conjunction with the Chief
Medical Officer (CMO) of the Department of Homeland Security
(DHS or Department), to establish uniform standards and
training for an initial medical screening of all individuals
apprehended by U.S. Border Patrol, with priority given to
children under the age of 18. The bill provides deadlines for
screenings to be completed and specifies elements that must be
a part of the screening. These efforts would establish a
consistent medical screening process to be carried out by
trained personnel at all U.S. borders. To further improve
medical screenings by U.S. Border Patrol, H.R. 3525 requires
the Department to establish a pediatric medical presence along
the border, research innovative solutions to address any
capability gaps, and mandates the use of electronic health
records for individuals in DHS custody. These are critical
steps to safeguard against further deaths at our borders.
Background and Need for Legislation
In December of 2018, the public learned about the deaths of
Jakelin Caal Maquin and Felipe Alonzo-Gomez, two migrant
children who passed away while in the custody of the U.S.
Border Patrol. Following their deaths, CBP announced new
medical screening procedures for children in its custody.
Despite this added measure, there have been additional deaths
in CBP custody, with a total of six children have passed away
since 2018. In the decade proceeding 2018, not one child died
while in CBP custody.\1\
---------------------------------------------------------------------------
\1\Commissioner Kevin McAleenan, CBS This Morning, December 26,
2018, ```We need a different approach,' says border protection chief
after 2nd migrant child dies in U.S. custody.'' Available at: https://
www.cbsnews.com/news/customs-and-border-protection-chief-kevin-
mcaleenan-on-migrant-child-death/.
---------------------------------------------------------------------------
The Committee received testimony in March 2019 from the
American Academy of Pediatrics that detailed the challenges of
providing medical care for children. Children's vital signs
have different normal parameters than adults and they vary by
age. When children become ill, the symptoms are subtler, can be
easily overlooked, and escalate quickly. A child can be happily
playing even as their physical systems are shutting down.
Conditions like the flu and sepsis can be particularly serious
for children because symptoms are not easily recognizable to
the untrained eye and with sepsis, each hour of delayed
treatment dramatically increases morbidity. Significantly, the
flu or sepsis played a role in the deaths of at least four of
the six children who passed away in CBP custody.\2\
---------------------------------------------------------------------------
\2\Robert Moore, ``Autopsy Offers Jarring New Details About the
Death of a 16-year-old Guatemalan Boy,'' Texas Monthly, July 24, 2019.
See also, Molly Hennessy-Fiske, ``Six migrant children have died in
U.S. custody. Here's what we know about them,'' Los Angeles Times, May
24, 2019.
---------------------------------------------------------------------------
Medical professionals continue to find that the CBP medical
screening process at the border is inadequate for children.\3\
Directing DHS to explore new approaches or solutions for the
medical screening process will help ensure that medical
screenings conducted at the border improve. Additionally, the
implementation of electronic health records for screened
individuals is critical. Such a system should be able to be
accessed by any DHS component at the border to reduce reliance
on hard copy records, lessen the risk of lost health records,
and ensure DHS personnel or contractors are not needlessly
duplicating medical checks or procedures. This will not only
ensure continuity of care but better facilitate custody
transfers between DHS components.
---------------------------------------------------------------------------
\3\Bob Ortega, ``Doctor says Border Patrol often misses early signs
of illness in migrant children,'' CNN, July 1, 2019.
---------------------------------------------------------------------------
Hearings
For the purposes of section 103(i) of H. Res. 6 of the
116th Congress, the following hearings were used to develop
H.R. 3525:
On March 6, 2019, the Committee held a
hearing entitled ``The Way Forward on Border
Security.'' The Committee received testimony from
Kirstjen Nielsen, Secretary of Homeland Security.
On March 26, 2019 the Subcommittee on Border
Security, Facilitation, and Operations held a hearing
entitled ``The Department of Homeland Security's Family
Separation Policy: Perspectives from the Border.'' The
Subcommittee received testimony from Jennifer Podkul,
Director of Policy, Kids in Need of Defense; Michelle
Brane, Director for Migrant Rights and Justice, Women's
Refugee Commission; Dr. Julie M. Linton, Co-Chair,
Immigrant Health Special Interest Group, American
Academy of Pediatrics; Tim Ballard, Founder and CEO,
Operation Underground Railroad.
On May 9, 2019, the Subcommittee on Border
Security, Facilitation, and Operations held a hearing
entitled ``A Review of the FY 2020 Budget Request for
U.S. Customs and Border Protection, U.S. Immigration
and Customs Enforcement, and U.S. Citizenship and
Immigration Services.'' The Subcommittee received
testimony from Robert E. Perez, Deputy Commissioner,
U.S. Customs and Border Protection; Matthew T. Albence,
Acting Director, U.S. Immigration and Customs
Enforcement; Tracy Renaud, Acting Deputy Director, U.S.
Citizenship and Immigration Services.
On May 22, 2019, the Committee held a
hearing entitled ``A Review of the Fiscal Year 2020
Budget Request for the Department of Homeland
Security.'' The Committee received testimony from Kevin
K. McAleenan, Acting Secretary of Homeland Security.
Committee Consideration
The Committee met on July 17, 2019, to consider H.R. 3525
and ordered the measure to be reported to the House with a
favorable recommendation, with amendment, by voice vote.
The following Amendments were offered and accepted by voice
vote:
An amendment in the Nature of a Substitute offered by Ms.
Underwood (#1);
An amendment offered by Ms. Underwood:
Page 2, line 1, insert ``, with priority given to children
who have not yet attained the age of 18,'' after
``individuals''.
Page 2, line 3, strike ``of such interdiction'' and insert
``after such interdiction, or six hours in the case of a high
priority individual. Such screening should be conducted by a
medical professional and should be developed in collaboration
with non-governmental experts in the delivery of health care in
humanitarian crises and in the delivery of health care to
children.''.
Page 2, line 7, insert ``in-person'' after ``initial''.
Page 2, line 13, insert ``(including a list of confiscated
medications and whether such have been replaced)'' after
``current medications''.
Page 2, line 16, insert the following: (D) A physical
examination that includes the screening of vital signs such as
body temperature, pulse rate, and blood pressure.''.
Page 2, line 23, insert the following:
``(4) Review by a medical professional of any
prescribed medication that is in the detainee's
possession or that was confiscated upon arrival
to determine if such medication may be kept by
such detainee for use during detention,
properly stored with appropriate access for use
during detention, or maintained with a
detainee's personal property.
(5) Chaperones for the physical examination
of minors, including, as appropriate, the
parent, legal guardian, or the such minors'
closest present adult relative, or a U.S.
Border Patrol agent of the same gender.
(c) Pediatric Expertise.--A pediatric medical expert shall
be on site in every U.S. Border Patrol sector, including at
U.S. Border Patrol processing centers and at U.S. Border Patrol
facilities at which 20 percent or more of detained individuals
over the immediately preceding six month period are minors. The
Chief of the U.S. Border Patrol shall prepare a plan to deploy
in-person or technology-facilitated medical consultation with a
licensed medical professional to U.S. Border Patrol facilities
that experience an increase in apprehensions of children
greater than 10 percent over the preceding 60 days.
(d) Definition. In this section, the term `high priority
individual' means an individual who self-identifies as having a
medical condition needing prompt attention, exhibits signs of
acute illness, is pregnant, is a child, or is elderly.''.
Page 3, line 6, insert the following: ``(b) Rule of
Construction.--Nothing in this section or the amendment made by
this section may be construed as authorizing U.S. Customs and
Border Protection to detain individuals for longer than 72
hours.''
Page 4, line 7, insert ``and non-governmental experts''
after ``expertise''.
Page 4, line 8, strike ``expertise in''.
Page 4, strike line 18 to end, and insert new section 4,
``SEC. 4. ELECTRONIC HEALTH RECORDS IMPLEMENTATION.
(a) In General.--Not later than 30 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.
Committee Votes
Clause 3(b) of rule XIII of the Rules of the House of
Representatives requires the Committee to list the recorded
votes on the motion to report legislation and amendments
thereto.
No recorded votes were requested during consideration of
H.R. 3525.
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.
Congressional Budget Office Estimate New Budget Authority, Entitlement
Authority, and Tax Expenditures
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 adopts as its
own the estimate of the estimate of new budget authority,
entitlement authority, or tax expenditures or revenues
contained in the cost estimate prepared by the Director of the
Congressional Budget Office.
H.R. 3525--Enhanced Border Security and Visa Entry Reform Act of 2002
CBO estimates that H.R. 3525 (enacted as Public Law 107-
173) will result in no significant net cost to the federal
government. The act will affect direct spending, but we
estimate that any net effects will not be significant.
H.R. 3525 sets the amount of the machine-readable visa
(MRV) fee at $65 and establishes a surcharge of $10 for issuing
an MRV in a nonmachine-readable passport. Under prior law, the
Secretary of State had the authority to raise MRV fees at his
discretion, and on June 1, 2002, the department implemented a
new schedule of consular fees, including an increase in the MRV
fee from $45 to $65. According to the State Department, it
would be nearly impossible to collect the $10 surcharge under
the existing application procedures because banks that collect
various application fees would be unable to distinguish
machine-readable passports from nonmachine-readable ones.
Because the State Department currently does not have a specific
plan for collecting the new surcharge, CBO cannot estimate the
additional amounts that will be collected and spent, but the
net effects will not be significant in any year.
H.R. 3525 also will increase the penalty from $300 to
$1,000 for improper submission of passenger manifests by
carriers entering United States ports. This provision will
increase both collections and spending of such penalties by the
Immigration and Naturalization Service (INS), but CBO estimates
that the net effect will be less than $500,000 annually.
The CBO staff contacts for this estimate are Mark Grabowicz
(for INS costs) and Sunita D'Monte (for State Department
costs). This estimate was approved by Peter H. Fontaine, Deputy
Assistant Director for Budget Analysis.
Duplicative Federal Programs
The Committee adopts as its own the estimate of Federal
mandates prepared by the Director of the Congressional Budget
Office pursuant to section 423 of the Unfunded Mandates Reform
Act.
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.
3525 would require the Department of Homeland Security to make
certain improvements to medical screening of individuals
apprehended at the border.
Advisory on Earmarks
In compliance with rule XXI of the Rules of the House of
Representatives, this bill, as reported, contains no
congressional earmarks, limited tax benefits, or limited tariff
benefits as defined in clause 9(d), 9(c), or 9(f) of the rule
XXI.
Section-by-Section Analysis of the Legislation
Section 1. Short title
This section provides that this bill may be cited as the
``U.S. Border Patrol Medical Screening Standards Act''.
Sec. 2. Uniform medical screening process for apprehensions
This section amends the Homeland Security Act to require
the Commissioner of U.S. Customs and Border Protection (CBP),
in coordination with the Department's Chief Medical Officer
(CMO), to establish uniform medical screening processes and
training not later than 30 days after enactment. The U.S.
Border Patrol, in turn, will be required to use these processes
to conduct consistent and efficient medical screening of all
apprehended individuals with priority given to children under
the age of 18. Such screening is to occur before the individual
is transferred from CBP custody or within 12 hours of
apprehension, whichever is shortest. An individual who self-
identifies as having a medical condition needing prompt
attention, exhibits signs of acute illness, is pregnant, is a
child, or is elderly, is to be considered a high-priority
individual and should be screened within six hours of
apprehension. This section lists the minimum requirements that
must be a part of the screening process and requires pediatric
medical expert presence on site in every U.S. Border Patrol
sector, processing center, and facility with a significant
presence of children.
This section also requires that not later than 60 days
after the establishment of uniform processes and training, the
CBP Commissioner ensure that the individuals conducting such
screening shall be trained on the process to ensure consistent
assessments and operations along the borders of the United
States.
Sec. 3. Research improvements to medical screening
Not later than one year after enactment, the Secretary of
Homeland Security, acting through the Under Secretary for
Science and Technology, in coordination with the CBP
Commissioner and CMO, are required to research innovative
solutions to address any capability gaps in the screening of
individuals apprehended by U.S. Border Patrol. In carrying out
this research, national professional associations and non-
governmental experts in relevant medical fields are to be
consulted. Any recommendations resulting from such research are
to be submitted by the Secretary to the House Committee on
Homeland Security and the Senate Committee on Homeland Security
and Governmental Affairs along with information on what actions
the Secretary plans in response to the recommendations.
Sec. 4. Electronic health records implementation
This section requires the Department's Chief Information
Officer (CIO) and CMO to establish an electronic health record
system for individuals in DHS custody along the borders of the
United States not later than 30 days after enactment. All the
DHS components who operate along the borders should be able to
access the records in the system. Not later than 120 days after
implementation of the system, the CIO and CMO will assess the
system to determine its interoperability and identify needed
improvements. Presently, DHS does not have a fully-integrated
electronic records system to ensure that each component
involved in the care of an apprehended individual has access to
any records from an initial health screening and information on
any health conditions warranting certain care.
Changes in Existing Law Made by the Bill, as Reported
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (new matter is
printed in italic and existing law in which no change is
proposed is shown in roman):
HOMELAND SECURITY ACT OF 2002
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Homeland
Security Act of 2002''.
(b) Table of Contents.--The table of contents for this Act is
as follows:
Sec. 1. Short title; table of contents.
* * * * * * *
Subtitle C--Miscellaneous Provisions
Sec. 437. Medical screening of individuals interdicted between ports of
entry.
* * * * * * *
TITLE IV--BORDER, MARITIME, AND TRANSPORTATION SECURITY
* * * * * * *
Subtitle C--Miscellaneous Provisions
* * * * * * *
SEC. 437. MEDICAL SCREENING OF INDIVIDUALS INTERDICTED BETWEEN PORTS OF
ENTRY.
(a) In General.--To improve border security and the
processing of individuals and families interdicted by the U.S.
Border Patrol between ports of entry, the Commissioner of U.S.
Customs and Border Protection, in coordination with the Chief
Medical Officer of the Department, shall, not later than 30
days after the date of the enactment of this section, establish
uniform processes and training to ensure consistent and
efficient medical screening of all individuals, with priority
given to children who have not yet attained the age of 18, so
interdicted before transfer from U.S. Customs and Border
Protection custody, but in no case longer than 12 hours after
such interdiction, or 6 hours in the case of a high priority
individual. Such screening should be conducted by a medical
professional and should be developed in collaboration with non-
governmental experts in the delivery of health care in
humanitarian crises and in the delivery of health care to
children.
(b) Screening Process Components.--At a minimum, the uniform
processes and training established under subsection (a) shall
include the following:
(1) Requirements for initial in-person screening that
includes documentation of the following:
(A) Visual assessment of overall physical and
behavioral state, including any possible
disability.
(B) A brief medical history, including
demographic information, current medications
(including a list of confiscated medications
and whether such have been replaced), and any
chronic or past illnesses.
(C) Any current medical complaints.
(D) A physical examination that includes the
screening of vital signs such as body
temperature, pulse rate, and blood pressure.
(2) Criteria for determining when to make a referral
to higher medical care and a process to execute such
referral.
(3) Recordkeeping requirements regarding how
information is to be recorded for each initial
screening under paragraph (1), including information on
the use of interpretation services.
(4) Review by a medical professional of any
prescribed medication that is in the detainee's
possession or that was confiscated upon arrival to
determine if such medication may be kept by such
detainee for use during detention, properly stored with
appropriate access for use during detention, or
maintained with a detainee's personal property.
(5) Chaperones for the physical examination of
minors, including, as appropriate, the parent, legal
guardian, or the such minors' closest present adult
relative, or a U.S. Border Patrol agent of the same
gender.
(c) Pediatric Expertise.--A pediatric medical expert shall be
on site in every U.S. Border Patrol sector, including at U.S.
Border Patrol processing centers and at U.S. Border Patrol
facilities at which 20 percent or more of detained individuals
over the immediately preceding six month period are minors. The
Chief of the U.S. Border Patrol shall prepare a plan to deploy
in-person or technology-facilitated medical consultation with a
licensed medical professional to U.S. Border Patrol facilities
that experience an increase in apprehensions of children
greater than 10 percent over the preceding 60 days.
(d) Definition.--In this section, the term ``high priority
individual'' means an individual who self-identifies as having
a medical condition needing prompt attention, exhibits signs of
acute illness, is pregnant, is a child, or is elderly.
(e) Training.--Not later than 60 days after the issuance of
the uniform processes and training established under subsection
(a), the Commissioner of U.S. Customs and Border Protection
shall ensure that any individual carrying out medical screening
under this section at a U.S. Customs and Border Protection
facility of individuals interdicted by the U.S. Border Patrol
between ports of entry shall complete training on such uniform
processes.
* * * * * * *
MINORITY VIEWS
H.R. 3525 directs the Border Patrol to conduct
comprehensive medical screenings of the thousands of people
they encounter every day within 12 hours of interdiction.
Border Patrol simply does not have the resources, medical
contract support, or physical space to meet the requirements of
H.R. 3525, especially with the record numbers of migrants it is
encountering on a daily basis. No funding is provided in this
bill to enable Customs and Border Protection (CBP) to achieve
this mandate.
The Border Patrol is responsible for short-term detention
and for expeditiously processing and coordinating the transfer
of illegal immigrants into the custody of agencies with the
capacity to hold them for longer terms of stay. The majority's
policy decision to deny funding for Immigration and Customs
Enforcement (ICE) bed space has severely degraded the U.S.
government's ability to safely hold illegal immigrants in long-
term facilities. As a result, illegal immigrants are being held
in Border Patrol custody much longer than was ever envisioned.
ICE provides comprehenive medical screenings for illegal
immigrants when they are transferred into their care, which
prior to the crisis took on average no more than 72 hours.
Instead of conflating which government agencies are responsible
for the comprehensive medical screening of illegal immigrants,
Congress should provide ICE the resources it needs to provide
proper care to the record number of illegal immigrants in
government custody.
H.R. 3525 also forces huge unfunded and unachievable
mandates on the Department of Homeland Security (DHS). The bill
requires DHS research innovative ways to conduct medical
screenings at the border. This new research and development
mandate would force the DHS to redirect its limited funding
away from homeland security research priorities that are
focused on preventing drugs, criminals, and terrorists from
entering the country, to instead research technology that is
not directly related to the mission of the Department.
This bill also forces DHS to establish within 30 days of
passage, an electronic health record system to track illegal
immigrant health records that is fully interoperable with all
components that operate along the border. That is a completely
unrealistic timeframe designed to result in failure. No funding
is provided in the bill to cover such major acquisition,
forcing the DHS to reprogram funding used for combating
terrorists and criminal organizations, and for responding to
man-made and natural disasters, to an IT system to track
illegal immigrant health records.
Health screenings for migrants are necessary to protect
public health. Congress should work with DHS and the Department
of Health and Human Services on ways to improve the delivery of
these screenings. Unfortunately, the unrealistic mandates
included H.R. 3525 are simply unachievable. As a result, H.R.
3525 will not improve the health screening process or protect
the health of migrants, Border Patrol, or the general public.
Mike Rogers.
[all]