,,ii #aafth ,,congress #ast ,session ,s4 #bace ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,july #ag1 #bjai,mr4 ,udall 7for himself1 ,mr4 ,brown1 and ,mr4 ,heinrich7 introduced the following bill2 which was read twice and referred to the ,committee on the ,judiciary ,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 for this ,act is as follows3 ,sec4 #a4 ,short title2 table of contents4,sec4 #b4 ,definitions4 ,sec4 #c4 ,initial health screening protocol4 ,sec4 #d4 ,water1 sanitation1 and hygiene4 ,sec4 #e4 ,food and nutrition4 ,sec4 #f4 ,shelter4 ,sec4 #g4 ,coordination and surge capacity4 ,sec4 #h4 ,training4 ,sec4 #i4 ,interfacility transfer of care4 ,sec4 #aj4 ,planning and initial implementation4 ,sec4 #aa4 ,contractor compliance4 ,sec4 #ab4 ,inspections4 ,sec4 #ac4 ,,gao report4 ,sec4 #ad4 ,rule of construction4 #b4 ,definitions ,in this ,act3 7#a7 ,interpretation services ,the term interpretation services includes translation services that are performed either in-person or through a telephone or video service4 7#b7 ,child ,the term child has the meaning given the term in section #aja7;b77#a7 of the ,immigration and ,nationality ,act 7#h ,u4,s4,c4 #aaja7;b77#a774 7#c7 ,u4,s4 customs and border protection facility ,the term ,u4,s4 ,customs and ,border ,protection ,facility includes-- 7,a7 ,u4,s4 ,border ,patrol stations2 7,b7 ports of entry2 7,c7 checkpoints2 7,d7 forward operating bases2 7,e7 secondary inspection areas2 and 7,f7 short-term custody facilities4 7#d7 ,forward operating base ,the term forward operating base means a permanent facility established by ,,cbp in forward or remote locations1 and designated as such by ,,cbp4 #c4 ,initial health screening protocol 7a7 ,in general ,the ,commissioner of ,u4,s4 ,customs and ,border ,protection 7referred to in this ,act as the 8,commissioner071 in consultation with the ,secretary of ,health and ,human ,services1 the ,administrator of the ,health ,resources and ,services ,administration1 and nongovernmental experts in the delivery of health care in humanitarian crises and in the delivery of health care to children1 shall develop guidelines and protocols for the provision of health screenings and appropriate medical care for individuals in the custody of ,u4,s4 ,customs and ,border ,protection 7referred to in this ,act as 8,,cbp071 as required under this section4 7b7 ,initial screening and medical assessment ,the ,commissioner shall ensure that any individual who is detained in the custody of ,,cbp 7referred to in this ,act as a 8detainee07 receives an initial in-person screening by a licensed medical professional in accordance with the standards described in subsection 7c7-- 7#a7 to assess and identify any illness1 condition1 or age-appropriate mental or physical symptoms that may have resulted from distressing or traumatic experiences2 7#b7 to identify acute conditions and high-risk vulnerabilities2 and 7#c7 to ensure that appropriate healthcare is provided to individuals as needed1 including pediatric1 obstetric1 and geriatric care4 7c7 ,standardization of initial screening and medical assessment 7#a7 ,in general ,the initial screening and medical assessment required under subsection 7b7 shall include-- 7,a7 an interview and the use of a standardized medical intake questionnaire or the equivalent2 7,b7 screening of vital signs1 including pulse rate1 body temperature1 blood pressure1 oxygen saturation1 and respiration rate2 7,c7 screening for blood glucose for known or suspected diabetics2 7,d7 weight assessment of detainees who are younger than #ab years of age2 7,e7 a physical examination2 and 7,f7 a risk assessment and the development of a plan for monitoring and care1 as appropriate4 7#b7 ,prescription medication ,the medical professional conducting the initial screening and medical assessment shall review any prescribed medication that is in the detainee's possession or that was confiscated by ,,cbp upon arrival and determine if the medication may be kept by the detainee for use during detention1 properly stored by ,,cbp with appropriate access for use during detention1 or maintained with the detained individual's personal property4 ,a detainee may not be denied the use of necessary and appropriate medication for the management of the detainee's chronic illness4 7#c7 ,rule of construction ,nothing in this subsection may be construed as requiring detainees to disclose their medical status or history4 7d7 ,timing 7#a7 ,in general ,except as provided in paragraph 7#b71 the initial screening and medical assessment required under this section shall take place as soon as practicable1 but not later than #ab hours after a detainee's arrival at a ,,cbp facility4 7#b7 ,high-priority individuals ,the initial screening and medical assessment required under this section shall take place as soon as practicable1 but not later than #f hours after a detainee's arrival at a ,,cbp facility if the individual reasonably self-identifies as having a medical condition that requires prompt medical attention or is-- 7,a7 exhibiting signs of acute or potentially severe physical or mental illness1 or otherwise has an acute or chronic physical or mental disability or illness2 7,b7 pregnant2 7,c7 a child 7with priority given1 as appropriate1 to the youngest children72 or 7,d7 elderly4 7e7 ,further care 7#a7 ,in general ,if1 as a result of the initial health screening and medical assessment1 the licensed medical professional conducting the screening or assessment determines that #a or more of the detainee's vital sign measurements are outside normal ranges in accordance with the ,national ,emergency ,services ,education ,standards1 or if the detainee is identified as high-risk or in need of medical intervention1 the detainee shall be provided1 as expeditiously as possible1 with an in-person or technology-facilitated medical consultation with a licensed emergency care professional4 7#b7 ,re-evaluation 7,a7 ,in general ,detainees described in paragraph 7#a7 shall be reevaluated within #bd hours and monitored thereafter as determined by an emergency care professional4 7,b7 ,reevaluation prior to transportation ,in addition to the reevaluations under subparagraph 7,a71 detainees shall have all vital signs reevaluated and be cleared as safe to travel by a medical professional before being transported4 7#c7 ,pyschological and mental care ,the ,commissioner shall ensure that detainees who have experienced physical or sexual violence or who have experienced events that may cause severe trauma or toxic stress1 are provided access to basic1 humane1 and supportive psychological assistance4 7f7 ,interpreters ,to ensure that health screenings and medical care required under this section are carried out in the best interests of the detainee1 the ,commissioner shall ensure that language-appropriate interpretation services1 including indigenous languages1 are provided to each detainee and that each detainee is informed of the availability of interpretation services4 7g7 ,chaperones ,to ensure that health screenings and medical care required under this section are carried out in the best interests of the detainee-- 7#a7 the ,commissioner shall establish guidelines for and ensure the presence of chaperones for all detainees during medical screenings and examinations consistent with relevant guidelines in the ,american ,medical ,association and ,american ,association of ,pediatrics ,code of ,medical ,ethics2 and 7#b7 to the extent practicable1 the physical examination of a child shall always be performed in the presence of a parent or legal guardian or in the presence of the detainee's closest present adult relative if a parent or legal guardian is unavailable4 7h7 ,documentation ,the ,commissioner shall ensure that the health screenings and medical care required under this section1 along with any other medical evaluations and interventions for detainees1 are documented in accordance with commonly accepted standards in the ,united ,states for medical record documentation4 ,such documentation shall be provided to any individual who received a health screening and subsequent medical treatment upon release from ,,cbp custody4 7i7 ,infrastructure and equipment ,the ,commissioner or the ,administrator of ,general ,services shall ensure that each location to which detainees are first transported after an initial encounter with an agent or officer of ,,cbp has-- 7#a7 a private space that provides a comfortable and considerate atmosphere for the patient and that ensures the patient's dignity and right to privacy during the health screening and medical assessment and any necessary follow-up care2 7#b7 all necessary and appropriate medical equipment and facilities to conduct the health screenings and follow-up care required under this section1 to treat trauma1 to provide emergency care1 including resuscitation of individuals of all ages1 and to prevent the spread of communicable diseases2 7#c7 basic over-the-counter medications appropriate for all age groups2 and 7#d7 appropriate transportation to medical facilities in the case of a medical emergency1 or an on-call service with the ability to arrive at the ,,cbp facility within #cj minutes4 7j7 ,personnel ,the ,commissioner or the ,administrator of ,general ,services shall ensure that each location to which detainees are first transported after an initial encounter has onsite at least #a licensed medical professional to conduct health screenings4 ,other personnel that are or may be necessary for carrying out the functions described in this section1 such as licensed emergency care professionals1 specialty physicians 7including physicians specializing in pediatrics1 family medicine1 obstetrics and gynecology1 geriatric medicine1 internal medicine1 and infectious diseases71 nurse practitioners1 other nurses1 physician assistants1 licensed social workers1 mental health professionals1 public health professionals1 dieticians1 interpreters1 and chaperones1 shall be located on site to the extent practicable1 or if not practicable1 shall be available on call4 7k7 ,ethical guidelines ,the ,commissioner shall ensure that all medical assessments and procedures conducted pursuant to this section are conducted in accordance with ethical guidelines in the applicable medical field1 and respect human dignity4 #d4 ,water1 sanitation1 and hygiene ,the ,commissioner shall ensure that detainees have access to-- 7#a7 not less than #a gallon of drinking water per day1 and age-appropriate fluids as needed2 7#b7 a private1 safe1 clean1 and reliable permanent or portable toilet with proper waste disposal and a hand washing station1 with not less than #a toilet available for every #ab male detainees1 and #a toilet for every #h female detainees2 7#c7 a clean diaper changing facility1 which includes proper waste disposal1 a hand washing station1 and unrestricted access to diapers2 7#d7 the opportunity to bathe daily in a permanent or portable shower that is private and secure2 and 7#e7 products for individuals of all age groups and with disabilities to maintain basic personal hygiene1 including soap1 a toothbrush1 toothpaste1 adult diapers1 and feminine hygiene products1 as well as receptacles for the proper storage and disposal of such products4 #e4 ,food and nutrition ,the ,commissioner shall ensure that detainees have access to-- 7#a7 #c meals per day including-- 7,a7 in the case of an individual who is at least #ab years of age1 a diet that contains not less than #b1jjj calories per day2 and 7,b7 in the case of a child who is younger than #ab years of age1 a diet that contains an appropriate number of calories per day based on the child's age and weight2 7#b7 accommodations for any dietary needs or restrictions2 and 7#c7 access to food in a manner that follows applicable food safety standards4 #f4 ,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 guardian unless such an arrangement poses safety or security concerns4 ,in no case shall a minor who is detained apart from an adult relative or legal guardian as a result of such safety or security concerns be detained with other adults4 7#c7 ,in the case of an unaccompanied minor arriving in the ,united ,states without an adult relative or legal guardian1 such child shall be detained in an age-appropriate facility and shall not be detained with adults4 7#d7 ,a detainee with a temporary or permanent disability shall be held in a manner that provides for his or her safety1 comfort1 and security4 7#e7 ,no detainee shall be placed in a room for any period of time if the detainee's placement would exceed the maximum occupancy level as determined by the appropriate building code1 fire marshall1 or other authority4 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 who are in custody for more than #dh hours 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 lighting and noise levels that are safe and conducive for sleeping throughout the night 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 to provide for the safety of the detained population and to prevent sexual abuse and physical harm of vulnerable detainees4 #g4 ,coordination and surge capacity ,the ,secretary of ,homeland ,security shall enter into memoranda of understanding with appropriate ,federal agencies1 such as the ,department of ,health and ,human ,services1 and applicable emergency government relief services1 as well as contracts with health care1 public health1 social work1 and transportation professionals1 for purposes of addressing surge capacity and ensuring compliance with this ,act4 #h4 ,training ,the ,commissioner shall ensure that ,,cbp personnel assigned to each short-term custodial facility are professionally trained1 including continuing education as the ,commissioner deems appropriate1 in all subjects necessary to ensure compliance with this ,act1 including-- 7#a7 humanitarian response protocols and standards2 7#b7 indicators of physical and mental illness1 and medical distress in children and adults2 7#c7 indicators of child sexual exploitation and effective responses to missing migrant children2 and 7#d7 procedures to report incidents of suspected child sexual abuse and exploitation directly to the ,national ,center for ,missing and ,exploited ,children4 #i4 ,interfacility transfer of care 7a7 ,transfer ,when a detainee is discharged from a medical facility or emergency department1 the ,commissioner shall ensure that responsibility of care is transferred from the medical facility or emergency department to an accepting licensed health care provider of ,,cbp4 7b7 ,responsibilities of accepting providers ,an accepting licensed health care provider receiving a detainee shall review the medical facility or emergency department's evaluation1 diagnosis1 treatment1 management1 and discharge care instructions with respect to the detainee to assess the safety of the discharge and transfer and to provide necessary follow-up care4 #aj4 ,planning and initial implementation 7a7 ,planning ,not later than #fj days after the date of enactment of this ,act1 the ,secretary of ,homeland ,security shall submit a detailed plan to ,congress that delineates the timeline1 process1 and challenges of carrying out the requirements of this ,act4 7b7 ,implementation ,the ,secretary of ,homeland ,security shall ensure that the requirements of this ,act are implemented not later than #f months after the date of the enactment of this ,act4 #aa4 ,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 under this ,act4 #ab4 ,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 administered by ,,cbp or contractors of ,,cbp2 and 7#b7 submit reports to ,congress that-- 7,a7 describe the results of the inspections conducted pursuant to paragraph 7#a72 and 7,b7 relate to custody operations4 7b7 ,particular attention ,in carrying out subsection 7a71 the ,inspector ,general shall pay particular attention to-- 7#a7 the degree of compliance by ,,cbp with the requirements under this ,act2 7#b7 remedial actions taken by ,,cbp2 and 7#c7 the health needs of detainees4 7c7 ,access to facilities ,the ,commissioner may not deny a ,member of ,congress entrance to any facility or building used1 owned1 or operated by ,,cbp4 #ac4 ,,gao report 7a7 ,in general ,the ,comptroller ,general of the ,united ,states shall-- 7#a7 not later than #f months after the date of the 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 the enactment of this ,act1 submit a report to ,congress on the results of such study4 7b7 ,issues ,to be studied ,the study required under 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 #ad4 ,rule of construction ,nothing in this ,act may be construed to authorize ,,cbp to detain individuals for longer than #gb hours4