,,ii #aahth ,,congress #ast ,session ,s4 #bhfd ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,september #bj1 #bjbc ,mr4 ,lujn 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 all 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 ,u4,s4 ,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 sanitation 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 ,government ,accountability ,office report4 ,sec4 #ad4 ,publication of data on complaints of sexual abuse at ,u4,s4 ,customs and ,border ,protection facilities4 ,sec4 #ae4 ,rules of construction4 #b4 ,definitions ,in this ,act3 7#a7 ,,cbp ,the term ,,cbp means ,u4,s4 ,customs and ,border ,protection4 7#b7 ,child ,the term child has the meaning given such term in section #aja7;b77#a7 of the ,immigration and ,nationality ,act 7#h ,u4,s4,c4 #aaja7;b77#a774 7#c7 ,commissioner ,the term ,commissioner means the ,commissioner of ,u4,s4 ,customs and ,border ,protection4 7#d7 ,detainee ,the term detainee means any individual who is detained in ,,cbp custody4 7#e7 ,forward operating base ,the term forward operating base means a permanent facility that has been established by ,,cbp in a forward or remote location and has been so designated by ,,cbp4 7#f7 ,interpretation services ,the term interpretation services includes translation services that are performed in person or through a telephone or video service4 7#g7 ,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 #c4 ,initial health screening protocol 7a7 ,in general ,the ,commissioner1 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 detainees1 as required under this section4 7b7 ,initial screening and medical assessment ,the ,commissioner shall ensure that all detainees receive an initial in-person screening by a licensed medical professional in accordance with the standards described in subsection 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 health care 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 of detainees 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 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 7,a7 ,in general ,the medical professional conducting the screening pursuant to subsection 7b7 shall-- 7i7 review any prescribed medication that is in the detainee's possession or that was confiscated by ,,cbp upon arrival2 and 7ii7 determine if such medication should be-- 7,i7 kept by the detainee for use during detention2 7,,ii7 properly stored by ,,cbp1 with appropriate access for use during detention2 or 7,,iii7 maintained with the detained individual's personal property4 7,b7 ,right to medication ,a detainee may not be denied the use of necessary and appropriate medication for the management of the detainee's 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 described in subsections 7b7 and 7c7 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 referred to in paragraph 7#a7 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-- 7,a7 reasonably self-identifies as having a medical condition that requires prompt medical attention2 or 7,b7 is-- 7i7 exhibiting signs of acute or potentially severe physical or mental illness1 or otherwise has an acute or chronic physical or mental disability or illness2 7ii7 pregnant2 7iii7 a child 7with priority given1 as appropriate1 to the youngest children72 or 7iv7 elderly4 7e7 ,further care 7#a7 ,in general ,if1 as a result of the initial health screening and medical assessment described in subsections 7b7 and 7c71 the licensed medical professional conducting such screening or assessment determines that #a or more of the detainee's vital sign measurements are significantly outside normal ranges1 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 ,reevaluation 7,a7 ,in general ,each detainee described in paragraph 7#a7-- 7i7 shall be reevaluated not later than #bd hours after the consultation required under such paragraph2 and 7ii7 7,i7 shall be monitored thereafter as determined by an emergency care professional2 or 7,,ii7 if the detainee is a child1 shall be monitored thereafter as determined by a licensed emergency care professional with a background in pediatric care4 7,b7 ,reevaluation before travel ,in addition to the reevaluations required under subparagraph 7,a71 detainees described in paragraph 7#a71 before being transported to another location-- 7i7 shall have all of their vital signs reevaluated2 and 7ii7 shall be cleared by a medical professional as being able to travel safely4 7#c7 ,psychological 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-- 7#a7 language-appropriate interpretation services1 including interpretation of indigenous languages1 are provided to each detainee2 and 7#b7 each detainee is informed of the availability of such 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 for1 and ensure the presence of1 chaperones for all detainees during medical screenings and examinations in accordance with relevant guidelines in the ,american ,medical ,association ,code of ,medical ,ethics and recommendations of the ,american ,academy of ,pediatrics2 and 7#b7 to the extent practicable1 the physical examination of a child shall always be performed in the presence of-- 7,a7 a parent or legal guardian2 or 7,b7 the detainee's closest present adult relative1 if a parent or legal guardian is unavailable4 7h7 ,documentation ,the ,commissioner shall ensure that-- 7#a7 the health screenings and medical care required under this section and any other medical evaluations and interventions for detainees are documented in accordance with commonly accepted standards in the ,united ,states for medical record documentation2 and 7#b7 such documentation is 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-- 7,a7 provides a comfortable and considerate atmosphere for the patient2 and 7,b7 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-- 7,a7 to conduct the health screenings and follow-up care required under this section2 7,b7 to treat trauma2 7,c7 to provide emergency care1 including resuscitation of individuals of all ages2 and 7,d7 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 ,services1 as the case may be1 shall ensure that each location to which detainees are first transported after an initial encounter has-- 7#a7 at least #a licensed medical professional on site to conduct health screenings2 and 7#b7 other personnel that are or may be necessary for carrying out the functions described in subsection 7e71 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 on site to the extent practicable1 or1 if not practicable1 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 field and respect human dignity4 #d4 ,water1 sanitation and hygiene ,the ,commissioner shall ensure that all detainees have access to-- 7#a7 not less than #a gallon of drinking water per person per day1 in addition to any other age-appropriate fluids that may be needed2 7#b7 a private1 safe1 clean1 and reliable permanent or portable toilet with proper waste disposal and a hand washing station1 with not fewer than #a toilet available for every #ab male detainees1 and not fewer than #a toilet available 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 for individuals with disabilities to maintain basic personal hygiene1 including soap1 a toothbrush1 toothpaste1 adult diapers1 feminine hygiene products1 and 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 day1 including-- 7,a7 for individuals #ab years of age or older1 a diet that contains not fewer than #b1jjj calories per day2 and 7,b7 for children 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 in each facility at which a detainee is detained-- 7#a7 except as provided in paragraph 7#b71 males and females are detained separately2 7#b7 for any minor child arriving in the ,united ,states with an adult relative or legal guardian1 such child-- 7,a7 is detained with such relative or legal guardian unless such an arrangement poses safety or security concerns2 and 7,b7 if such child is detained apart from an adult relative or legal guardian as a result of such safety or security concerns1 is not detained with adults2 7#c7 for any unaccompanied minor arriving in the ,united ,states without an adult relative or legal guardian1 such child is detained in an age-appropriate facility and not detained with adults2 7#d7 a detainee with a temporary or permanent disability is held in an accessible location and in a manner that provides for his or her safety1 comfort1 and security1 with accommodations provided to the extent needed2 7#e7 no detainee is placed in a room for any period if such placement would exceed the maximum occupancy level as determined by the appropriate building code1 fire marshal1 or other authority2 7#f7 each detainee is provided with temperature appropriate clothing and bedding2 7#g7 the facility is well lit and well ventilated1 with the humidity and temperature kept at comfortable levels 7between #fh and #gd degrees ,fahrenheit72 7#h7 detainees who are in custody for more than #dh hours are given access to the outdoors for not less than #a hour during the daylight hours during each #bd-;hour period2 7#i7 detainees are allowed to practice their religion or to not practice a religion1 at their discretion2 7#aj7 detainees are given access to lighting and noise levels that are safe and conducive for sleeping throughout the night between the hours of #aj3jj p4m4 and #f3jj a4m2 7#aa7 ,,cbp officers1 employees1 and contracted personnel-- 7,a7 follow medical standards for the isolation and prevention of communicable diseases2 and 7,b7 ensure the physical and mental safety of detainees who identify as lesbian1 gay1 bisexual1 transgender1 or intersex2 7#ab7 the facility has video monitoring-- 7,a7 to provide for the safety of the detainees2 and 7,b7 to prevent sexual abuse and physical harm of vulnerable detainees2 7#ac7 there is posted or otherwise made available in all areas where detainees are located a language appropriate ,detainee ,bill of ,rights 7including indigenous languages71 which specifies all rights afforded to detainees under this ,act2 and 7#ad7 the facility certifies that-- 7,a7 the video monitoring required under paragraph 7#ab7 is properly working at all times2 and 7,b7 the videos resulting from video monitoring are preserved for at least #ij days4 #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 government emergency relief services1 and shall enter into 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 by receiving such continuing education as the ,commissioner determines 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 services department1 the ,commissioner shall ensure that responsibility of care is transferred from the medical facility or emergency services department to an accepting licensed ,,cbp health care provider4 7b7 ,responsibilities of accepting providers ,each accepting licensed ,,cbp health care provider shall review the medical facility or emergency department's evaluation1 diagnosis1 treatment1 management1 and discharge care instructions-- 7#a7 to assess the safety of the discharge and transfer2 and 7#b7 to provide necessary follow-up care4 #aj4 ,planning and initial implementation 7a7 ,planning ,not later than #fj days after the date of the enactment of this ,act1 the ,secretary of ,homeland ,security shall submit a detailed plan to ,congress that describes the timeline1 process1 and challenges of implementing the requirements under this ,act4 7b7 ,implementation ,the ,secretary of ,homeland ,security shall ensure that the requirements under 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 comply 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 to ,congress-- 7,a7 reports on the results of the inspections conducted pursuant to paragraph 7#a72 and 7,b7 other reports related 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 7#c7 the health needs of detainees2 and 7#d7 the degree of compliance with part #aae of title #f1 ,code of ,federal ,regulations 7commonly known as the ,standards to ,prevent1 ,detect1 and ,respond to ,sexual ,abuse and ,assault in ,confinement ,facilities74 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 ,government ,accountability ,office report 7a7 ,in general ,the ,comptroller ,general of the ,united ,states-- 7#a7 not later than #f months after the date of the enactment of this ,act1 shall 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 shall submit a report to ,congress containing the results of the study required under paragraph 7#a74 7b7 ,issues ,to be studied ,the study required under subsection 7a77#a7 shall examine-- 7#a7 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 the requirements under this ,act2 and 7#b7 the extent to which ,,cbp personnel1 in carrying out this ,act1 make abusive1 derisive1 profane1 or harassing statements or gestures1 or engage in any other conduct evidencing hatred or invidious prejudice to or about #a person or group on account of race1 color1 religion1 national origin1 sex1 sexual orientation1 age1 or disability1 including on social media4 #ad4 ,publication of data on complaints of sexual abuse at ,u4,s4 ,customs and ,border ,protection facilities ,not later than #ij days after the date of the enactment of this ,act1 the ,secretary of ,homeland ,security1 acting in coordination with the ,office of ,inspector ,general and the ,office for ,civil ,rights and ,civil ,liberties of the ,department of ,homeland ,security1 shall publicly release aggregate data on complaints of sexual abuse at ,,cbp facilities on its website on a quarterly basis1 excluding any personally identifiable information that may compromise the confidentiality of individuals who reported such abuse4 #ae4 ,rules of construction ,nothing in this ,act may be construed as-- 7#a7 authorizing ,,cbp to detain individuals for longer than #gb hours2 7#b7 contradicting the ,march #g1 #bjad1 ,department of ,homeland ,security rule adopting ,standards to ,prevent1 ,detect1 and ,respond to ,sexual ,abuse and ,assault in ,confinement ,facilities1 which includes a zero tolerance policy prohibiting all forms of sexual abuse and assault of individuals in ,u4,s4 ,customs and ,border ,protection custody1 including in holding facilities1 during transport1 and during processing2 7#c7 contradicting current protocols related to ,department of ,homeland ,security background checks in the hiring process2 7#d7 restricting the ,department of ,homeland ,security from denying employment to1 or terminating the employment of1 any individual who-- 7,a7 would be or is involved with the handling or processing at holding facilities1 during transport1 or during processing1 or care of detainees1 including the care of children2 and 7,b7 has been convicted of a sex crime or other offense involving a child victim2 or 7#e7 affecting the obligation to fully comply with all applicable immigration laws1 including being subject to any penalties1 fines1 or other sanctions4