,i #aafth ,,congress #ast ,session ,h4 ,r4 #cbci ,,in ,,the ,,house ,,of ,,representatives ,june #ab1 #bjai,mr4 ,ruiz 7for himself1 ,mr4 ,castro of ,texas1 ,ms4 ,roybal-,allard1 ,mr4 ,lujn1 ,mr4 ,nadler1 ,ms4 ,lofgren1 ,ms4 ,escobar1 ,mr4 ,cisneros1 ,mr4 ,espaillat1 ,mrs4 ,napolitano1 ,ms4 ,mucarsel-,powell1 ,mr4 ,soto1 ,mr4 ,gomez1 ,ms4 ,norton1 ,ms4 ,omar1 ,mr4 ,ted ,lieu of ,california1 ,ms4 ,ocasio-,cortez1 ,mr4 ,sires1 ,mr4 ,levin of ,california1 ,mr4 ,brown of ,maryland1 ,ms4 ,jayapal1 ,mr4 ,jeffries1 ,mr4 ,aguilar1 ,mr4 ,richmond1 ,mr4 ,brendan ,f4 ,boyle of ,pennsylvania1 ,mr4 ,thompson of ,mississippi1 ,mr4 ,cleaver1 ,mr4 ,gallego1 ,ms4 ,velzquez1 ,mr4 ,carbajal1 ,mr4 ,crdenas1 ,ms4 ,lee of ,california1 ,ms4 ,torres ,small of ,new ,mexico1 ,mr4 ,costa1 ,mr4 ,vargas1 ,mr4 ,veasey1 ,ms4 ,clarke of ,new ,york1 ,ms4 ,kelly of ,illinois1 ,mr4 ,payne1 ,mr4 ,takano1 ,mr4 ,kildee1 ,mr4 ,suozzi1 ,mr4 ,moulton1 ,mr4 ,green of ,texas1 ,mr4 ,peters1 ,mr4 ,sean ,patrick ,maloney of ,new ,york1 ,ms4 ,haaland1 ,ms4 ,speier1 ,mrs4 ,dingell1 ,ms4 ,pingree1 ,ms4 ,titus1 ,mr4 ,connolly1 ,ms4 ,bass1 ,ms4 ,moore1 ,mr4 ,lawson of ,florida1 ,ms4 ,jackson ,lee1 ,mr4 ,neal1 ,ms4 ,kaptur1 ,mr4 ,perlmutter1 ,mrs4 ,kirkpatrick1 ,mr4 ,swalwell of ,california1 ,mr4 ,schrader1 ,mr4 ,casten of ,illinois1 ,mr4 ,gonzalez of ,texas1 ,ms4 ,brownley of ,california1 ,mr4 ,pappas1 ,mr4 ,engel1 ,mr4 ,kennedy1 ,mr4 ,rush1 ,mr4 ,blumenauer1 ,ms4 ,matsui1 ,mr4 ,thompson of ,california1 ,ms4 ,hill of ,california1 ,mr4 ,rouda1 ,mr4 ,peterson1 ,mr4 ,vela1 ,mr4 ,meeks1 ,mr4 ,garamendi1 ,mr4 ,pocan1 ,mr4 ,case1 ,mr4 ,cox of ,california1 ,ms4 ,barragn1 ,mr4 ,keating1 ,mr4 ,garca of ,illinois1 ,mr4 ,lowenthal1 ,mr4 ,mc,govern1 ,ms4 ,judy ,chu of ,california1 ,mr4 ,krishnamoorthi1 ,mr4 ,heck1 ,mrs4 ,beatty1 ,mr4 ,levin of ,michigan1 ,mr4 ,raskin1 ,mrs4 ,trahan1 ,ms4 ,castor of ,florida1 ,ms4 ,schakowsky1 ,mr4 ,sarbanes1 ,mr4 ,tonko1 ,mr4 ,o',halleran1 ,ms4 ,de,gette1 ,ms4 ,stevens1 ,mr4 ,mc,nerney1 ,ms4 ,clark of ,massachusetts1 ,mr4 ,michael ,f4 ,doyle of ,pennsylvania1 ,ms4 ,dean1 ,mr4 ,larson of ,connecticut1 ,mr4 ,deutch1 ,mr4 ,harder of ,california1 ,mr4 ,grijalva1 ,mr4 ,cicilline1 ,mr4 ,stanton1 ,mr4 ,panetta1 ,mr4 ,kilmer1 and ,ms4 ,del,bene7 introduced the following bill2 which was referred to the ,committee on the ,judiciary1 and in addition to the ,committee on ,homeland ,security1 for a period to be subsequently determined by the ,speaker1 in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned ,a ,,bill ,to require ,u4,s4 ,customs and ,border ,protection to perform an initial health screening on detainees1 and for other purposes4 #a4 ,short title2 table of contents 7a7 ,short title ,this ,act may be cited as the ,humanitarian ,standards for ,individuals in ,customs and ,border ,protection ,custody ,act4 7b7 ,table of contents ,the table of contents of this ,act is as follows3 ,sec4 #a4 ,short title2 table of contents4 ,sec4 #b4 ,initial health screening protocol4 ,sec4 #c4 ,water1 sanitation1 and hygiene4 ,sec4 #d4 ,food and nutrition4 ,sec4 #e4 ,shelter4 ,sec4 #f4 ,coordination and surge capacity4 ,sec4 #g4 ,training4 ,sec4 #h4 ,interfacility transfer of care4 ,sec4 #i4 ,planning and initial implementation4 ,sec4 #aj4 ,contractor compliance4 ,sec4 #aa4 ,inspections4 ,sec4 #ab4 ,,gao report4 ,sec4 #ac4 ,rule of construction4 #b4 ,initial health screening protocol 7a7 ,in general 7#a7 ,screening required ,the ,commissioner of ,u4,s4 ,customs and ,border ,protection 7referred to in this ,act as the ,commissioner7 shall ensure that any individual whom ,u4,s4 ,customs and ,border ,protection 7referred to in this ,act as ,,cbp7 detains 7referred to in this ,act as a detainee7 receives an initial health screening by a medical professional-- 7,a7 to identify acute conditions and high-risk vulnerabilities2 and 7,b7 to provide appropriate health care to subpopulations involving pediatrics1 obstetrics1 and geriatrics specialties4 7#b7 ,timing ,the screening required by paragraph 7#a7 shall be performed within-- 7,a7 #c hours of being initially detained for high-priority populations in accordance with subsection 7d72 and 7,b7 #ab hours of being initially detained for all other populations4 7b7 ,interpreters ,to ensure that health screenings and medical care required under subsections 7a7 and 7f7 are carried out in the best interests of the detainees receiving such screenings and care1 the ,commissioner shall-- 7#a7 provide such detainees with interpreters in the detainee's native or indigenous language2 and 7#b7 inform detainees of the availability of interpretation services4 7c7 ,chaperones ,to ensure that health screenings and medical care required under subsections 7a7 and 7f7 are carried out in the best interests of the detainees receiving such screenings and care-- 7#a7 the ,commissioner shall provide chaperones when necessary according to standard ,united ,states medical practice to protect a person's dignity1 culture1 and gender-specific sensitivities2 and 7#b7 the physical examination of infants1 toddlers1 children1 or any minors #ag years of age or younger shall1 to the extent practicable1 always be performed-- 7,a7 in the presence of a parent or legal guardian2 or 7,b7 in the absence of a parent or legal guardian1 in the presence of the detainee's closest present adult relative4 7d7 ,prioritization ,the ,commissioner shall ensure that the initial screening required by subsection 7a7 is prioritized and conducted within #c hours of being initially detained for the following high-priority populations3 7#a7 ,individuals who are exhibiting signs of acute or potentially severe physical or mental illness4 7#b7 ,pregnant women4 7#c7 ,infants4 7#d7 ,children4 7#e7 ,any minors #ag years of age or younger4 7#f7 ,elderly individuals4 7#g7 ,individuals who are visibly physically or mentally disabled4 7#h7 ,any other individual who self-identifies as having a medical condition that requires prompt medical attention1 such as the following3 7,a7 ,a disability4 7,b7 ,a mental health issue4 7,c7 ,,hiv positive4 7,d7 ,a chronic disease1 such as diabetes4 7e7 ,standardization of screening 7#a7 ,in general 7,a7 ,consultation and development of guidelines and protocol ,the ,commissioner1 in consultation with the ,secretary of ,health and ,human ,services and nongovernmental experts in delivery of health care in humanitarian crises1 shall develop guidelines and protocols for the health screenings and medical care required under subsections 7a7 and 7f74 7,b7 ,assessment of appropriate level of care ,the guidelines and protocols required by subparagraph 7,a7 shall require that each detainee be administered a health screening to assess and identify age-appropriate signs1 symptoms1 risks1 and experiences1 including mental health risks and distressing or traumatic experiences1 to determine the appropriate level of care needed4 7,c7 ,standardized medical intake ,the guidelines and protocols required by subparagraph 7,a7 shall ensure that each such screening makes use of a standardized medical intake questionnaire or the equivalent of such a questionnaire1 such as relevant portions of the ,performance-,based ,national ,detention ,standards questionnaire administered by ,u4,s4 ,immigration and ,customs ,enforcement4 7,d7 ,consultation ,in developing the guidelines and protocols required by subparagraph 7,a71 the ,commissioner shall consult with the ,administrator of the ,health ,resources and ,services ,administration regarding health screening and medical care under the ,emergency ,medical ,services for ,children ,program4 7#b7 ,contents ,the guidelines and protocols required by paragraph 7#a7 shall require1 with respect to each detainee-- 7,a7 an interview and questionnaire2 7,b7 screening for vital signs1 including pulse rate1 temperature1 blood pressure1 oxygen saturation1 and respiration rate2 7,c7 screening for blood glucose for known diabetics2 7,d7 weight for detainees under #ab years of age2 7,e7 a physical exam2 and 7,f7 an assessment and development of a plan for risk-assessment1 required interventions1 and continued monitoring and care4 7#c7 ,rule of construction ,nothing in this subsection shall be construed as requiring detainees to disclose their medical status or history4 7f7 ,further care 7#a7 ,in general ,if an initial health screening of a detainee displays values outside of normal ranges per ,national ,emergency ,services ,education ,standards or if an individual is identified as high-risk or is in need of medical intervention1 the ,commissioner shall ensure such detainee is provided with an in-person or technology-facilitated medical consultation with a readily available licensed emergency care professional4 7#b7 ,availability ,the ,commissioner shall ensure that-- 7,a7 a licensed emergency care professional is on call at all times with respect to detainees2 and 7,b7 appropriate emergency transportation is on site or on call to arrive on site within #cj minutes of being called4 7#c7 ,re-evaluations ,detainees who present with any abnormalities during a health screening under subsection 7a7 shall-- 7,a7 be re-evaluated and monitored as determined by the emergency care professional and at least once every #bd hours2 and 7,b7 notwithstanding subparagraph 7,a71 have safety health clearance prior to transportation1 including reevaluation of vital signs4 7g7 ,psychological and mental care ,the ,commissioner shall ensure that detainees who have experienced physical or sexual violence or other potentially life-threatening events1 or who have witnessed atrocities that may cause severe1 traumatic1 or toxic stress1 are provided psychological first aid1 including a basic1 humane1 and supportive response to ensure that basic needs are met4 7h7 ,documentation ,the ,commissioner shall ensure that the health screenings and medical care required under subsections 7a7 and 7f7 and any other medical evaluations and interventions for detainees are documented in accordance with commonly accepted standards in the ,united ,states for medical record documentation4 7i7 ,release from ,,cbp ,before being released from ,,cbp custody1 each detainee in a high-priority population1 or requiring intervention1 or in need of health care followup upon release1 shall receive medical records that outline the health screening and medical care that was conducted under this section with respect to the detainee1 as well as documentation of medical issues1 evaluations1 interventions1 and immunizations4 7j7 ,infrastructure1 equipment1 and personnel ,the ,commissioner and the ,administrator of ,general ,services1 as the case may be1 shall ensure that each location at which a detainee is first transported after such detainee's initial encounter with an agent or officer of ,,cbp has the following3 7#a7 ,a private space for the health screening required under subsection 7a71 including for any necessary follow-up exam or care management4 7#b7 ,appropriate equipment to carry out such screening1 monitor health1 provide emergency care1 treat traumas and perform resuscitations 7including paramedic bags with equipment suitable for neonates1 infants1 and toddlers74 7#c7 ,a designated area and necessary equipment to prevent the spread of communicable diseases4 7#d7 ,basic over-the-counter and prescription medications for all age groups1 including all pediatric age groups1 including the medications necessary to ensure that detainees are not deprived of their medication required to manage their chronic illness4 7#e7 ,a medical professional trained and certified to conduct such health screening4 7#f7 ,an emergency medicine physician or emergency care provider on site1 or if such a physician is not available1 an emergency medicine physician or emergency care provider on call at all times for consultation4 7#g7 ,other professionals to meet the requirements of this section1 such as physicians specializing in pediatrics1 family medicine1 emergency medicine1 obstetrics and gynecology1 geriatric medicine1 internal medicine1 and infectious diseases2 nurse practitioners2 other nurses2 physician assistants2 licensed social workers2 mental health professionals2 public health professionals2 and dieticians4 7#h7 ,interpreters on site1 or if an interpreter is not available1 an interpreter on call at all times4 7#i7 ,the capability to provide appropriate transportation in the case of a medical emergency on site or on call to arrive on site within #cj minutes4 7k7 ,ethical guidelines ,the ,commissioner shall ensure that all medical assessments and procedures conducted pursuant to this section-- 7#a7 are conducted in accordance with ethical guidelines in the applicable medical field2 and 7#b7 respect human dignity4 #c4 ,water1 sanitation1 and hygiene ,the ,commissioner shall ensure that a detainee has access to the following3 7#a7 ,not less than one gallon of drinking water per day1 including age-appropriate fluids4 7#b7 ,a private1 safe1 clean1 and reliable toilet with proper waste disposal and a hand washing station1 with not less than one toilet available for every #ab male detainees1 and #a toilet per #h female detainees4 7#c7 ,a clean diaper changing facility1 which includes proper waste disposal1 a hand washing station1 and unrestricted access to diapers4 7#d7 ,accommodations to ensure hygiene for elderly individuals and individuals with disabilities4 7#e7 ,the opportunity to bathe every day in a private and secure manner4 7#f7 ,adult diapers1 in the case of an individual who is incontinent4 7#g7 ,products to maintain basic personal hygiene1 including-- 7,a7 soap1 a toothbrush1 toothpaste1 and feminine hygiene products2 and 7,b7 proper handling and disposal methods for used products4 #d4 ,food and nutrition ,the ,commissioner shall ensure that a detainee has access to the following3 7#a7 ,in the case of an individual age #ab or older1 a diet that contains not less than #b1jjj calories per day4 7#b7 ,in the case of a child who is under the age of #ab1 a diet that contains an appropriate number of calories per day based on the child's age and weight4 7#c7 ,three meals per day4 7#d7 ,accommodations for any dietary need or restriction in the case of a pregnant or breastfeeding woman1 an infant1 a child1 an elderly individual1 an individual with a disability1 an individual with a food allergy1 or an individual with religious dietary restrictions4 7#e7 ,access to food in a manner that follows applicable food safety standards4 #e4 ,shelter ,the ,commissioner shall ensure that each facility at which a detainee is detained meets the following requirements3 7#a7 ,except as provided in paragraph 7#b71 males and females shall be detained separately4 7#b7 ,in the case of a minor child arriving in the ,united ,states with an adult relative or legal guardian1 such child shall be detained with such relative or legal guardian1 with family cohesion maintained-- 7,a7 unless this arrangement incites safety or security concerns2 and 7,b7 in no case shall such minor be detained apart from such adult relative or legal guardian1 pursuant to subparagraph 7,a71 with other adults4 7#c7 ,in the case of a minor child arriving in the ,united ,states without an adult relative or legal guardian1 such child-- 7,a7 shall be detained in an age-appropriate facility2 and 7,b7 shall not be detained with adults4 7#d7 ,a detainee with a disability1 including a temporary disability1 shall be held in a manner that provides for his or her safety1 comfort1 and security4 7#e7 ,there shall be no less than #b square meters of space for each detainee4 7#f7 ,each detainee shall be provided with temperature appropriate clothing and bedding4 7#g7 ,the facility shall be well lit and well ventilated1 with the humidity and temperature kept at comfortable levels 7between #fh and #gd degrees ,fahrenheit74 7#h7 ,detainees shall have access to the outdoors for not less than #a hour during the daylight hours during each #bd-;hour period4 7#i7 ,detainees shall have the ability to practice their religion or not to practice a religion1 as applicable4 7#aj7 ,detainees shall have access to sufficient time for sleeping without unnecessary disturbances 7including light and noise7 throughout the night1 between the hours of #aj p4m4 and #f a4m4 7#aa7 ,officers1 employees1 and contracted personnel of ,,cbp shall-- 7,a7 follow medical standards for the isolation and prevention of communicable diseases2 and 7,b7 ensure the physical and mental safety of lesbian1 gay1 bisexual1 transgender1 and intersex detainees4 7#ab7 ,the facility shall have video-monitoring-- 7,a7 to provide for the safety of children and disabled individuals1 or any safety need considerations2 and 7,b7 to prevent the sexual abuse or physical harm of vulnerable detainees4 #f4 ,coordination and surge capacity ,the ,secretary of ,homeland ,security1 acting through the ,commissioner or an operational commander or other appropriate official within the ,department of ,homeland ,security1 shall enter into memoranda of understanding with appropriate ,federal agencies1 such as the ,department of ,health and ,human ,services1 the ,federal ,emergency ,management ,agency1 and applicable emergency government relief services1 and contracts with health care1 public health1 social work1 and transportation professionals1 for purposes of coordinating-- 7#a7 compliance with this ,act2 and 7#b7 addressing surge capacity4 #g4 ,training ,the ,commissioner shall ensure that personnel of ,,cbp are professionally trained to focus on the following3 7#a7 ,annual humanitarian response and standards training to comply with this ,act4 7#b7 ,evidence of physical and mental illness1 including common signs of high-risk and medical distress in children and high-priority populations4 7#c7 ,vulnerabilities and indicators of child sexual exploitation and effective responses to missing migrant children including by leveraging the resources of the ,national ,center for ,missing and ,exploited ,children4 7#d7 ,procedures to report incidents of suspected child sexual abuse and exploitation directly to the ,cyber,tipline of the ,national ,center for ,missing and ,exploited ,children 7or any successor tipline74 #h4 ,interfacility transfer of care 7a7 ,transfer ,when a detainee is discharged from a medical facility or emergency department1 the ,commissioner shall ensure a transfer of responsibility of care from the medical provider at such medical facility or emergency department to an accepting licensed health care provider of ,,cbp4 7b7 ,responsibilities of accepting provider ,such accepting licensed health care provider shall review the medical facility or emergency department's evaluation1 diagnosis1 treatment1 management1 and discharge care instructions-- 7#a7 to assess for the safety of the discharge and transfer2 and 7#b7 to provide necessary follow-up care4 #i4 ,planning and initial implementation 7a7 ,planning ,no later than #cj days after the date of enactment of this ,act1 the ,secretary of ,homeland ,security shall submit a detailed plan to the ,congress delineating the timeline1 process1 and challenges of carrying this ,act4 7b7 ,implementation ,the ,secretary of ,homeland ,security shall ensure that this ,act is implemented not later than #f months after the date of enactment of this ,act4 #aj4 ,contractor compliance ,the ,secretary of ,homeland ,security shall ensure that all personnel contracted to carry out this ,act do so in accordance with the requirements of this ,act4 #aa4 ,inspections 7a7 ,in general ,the ,inspector ,general of the ,department of ,homeland ,security shall-- 7#a7 conduct unannounced inspections of ports of entry1 border patrol stations1 and detention facilities of or administered by ,,cbp or contractors of ,,cbp2 and 7#b7 submit to the ,congress reports on the results of the inspections under paragraph 7#a7 and other reports of the ,inspector ,general related to custody operations4 7b7 ,particular attention ,in carrying out subsection 7a71 the ,inspector ,general of the ,department of ,homeland ,security shall pay particular attention to-- 7#a7 the degree of compliance by ,,cbp with the requirements of this ,act2 7#b7 remedial actions taken by ,,cbp2 and 7#c7 the health needs of the detainees4 #ab4 ,,gao report 7a7 ,in general ,the ,comptroller ,general of the ,united ,states shall-- 7#a7 not later than #f months after the date of enactment of this ,act1 commence a study on implementation of1 and compliance with1 this ,act2 and 7#b7 not later than #a year after the date of enactment of this ,act1 submit a report to the ,congress on the results of such study4 7b7 ,issues ,to be studied ,the study required by subsection 7a7 shall examine the management and oversight by ,,cbp of ports of entry1 border patrol stations1 and other detention facilities1 including the extent to which ,,cbp and the ,department of ,homeland ,security have effective processes in place to comply with this ,act4 #ac4 ,rule of construction ,nothing in this ,act shall be construed to authorize ,,cbp to detain individuals for longer than #gb hours4