U.S. Border Patrol Medical Screening Standards Act

Floor Speech

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Mr. THOMPSON of Mississippi. Mr. Speaker, pursuant to House Resolution 577, I call up the bill (H.R. 3525) to amend the Homeland Security Act of 2002 to direct the Commissioner of U.S. Customs and Border Protection to establish uniform processes for medical screening of individuals interdicted between ports of entry, and for other purposes, and ask for its immediate consideration.

The Clerk read the title of the bill.

Mr. Speaker, H.R. 3525, the U.S. Border Patrol Medical Screening Standards Act, as amended, seeks to build on legislation passed by the House in July to strengthen the medical care and attention provided to migrants who cross our borders.

In July, in response to reports of inhumane conditions at our southern border and the death of six children who had been in CBP custody, the House approved a bill to require in-person medical screening by licensed medical professionals for apprehended individuals.

H.R. 3525 builds upon that measure by focusing on improving health screening processes and recordkeeping within DHS. The bill authored by the gentlewoman from Illinois (Ms. Underwood) takes a two-pronged approach.

First, it requires DHS to research innovative solutions for deficiencies in the medical screening it conducts at the border. This research is to be carried out in consultation with national medical professional associations that have expertise in emergency medicine, nursing, and pediatric care.

Importantly, in carrying out the research, DHS is directed to pay particular attention to the screening of children, pregnant women, the elderly, and other vulnerable populations.

Once completed, DHS is required to transmit to Congress information on what actions the Department plans to take in response to the research findings.

The second prong of H.R. 3525 is focused on driving DHS to improve interoperability among components responsible for the care of apprehended individuals. It does so by requiring DHS to set up an electronic health records system to track health screening and care of individuals in DHS custody. This system would create records that could be accessed by all the relevant DHS components.

The benefits of such a system are unmistakable:

A migrant's medical information cannot get lost.

There will be a clear system to track when any followup medication or medical attention is needed, ensuring cases will not fall through the cracks.

It will also avoid duplication of medical services and time delays due to lost or incomplete medical records.

As important, all the information gained from the initial medical screening will follow the children and adults as they are transferred to other DHS components.

Even though apprehension numbers have recently declined, we must take the lessons learned from the poor handling of the recent migrant crisis to heart and drive performance improvement within DHS.

H.R. 3525 represents a step in the right direction, and, as such, I urge my colleagues to support the legislation.

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Mr. THOMPSON of Mississippi. Underwood), sponsor of this legislation.

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Mr. THOMPSON of Mississippi. Roybal-Allard), the chairwoman of the House Appropriations Subcommittee on Homeland Security.

Miss RICE of New York. Mr. Speaker, six children have died in DHS custody over the past year.

On Christmas Day in 2018, 8-year old Felipe Alonzo Gomez died in the custody of U.S. Customs and Border Protection. He was the second child that month to die in CBP custody. And after his death, CBP implemented a new medical screening process for young children in their care.

However, as we soon learned, this process was not adequate, because four more children died in CBP custody from preventable illnesses and substandard living conditions.

Even after these new screening processes were put in place, both CBP personnel and their facilities along the southern border remained completely ill-equipped for months. That is why this past July, the House passed H.R. 3239, the Humanitarian Standards for Individuals in Customs and Border Protection Custody Act.

This bill would require DHS to improve screening processes and utilize professional medical staff. And it allocated other necessary resources to conduct effective initial medical screenings for all people in CBP custody.

Today, I am proud to support Congresswoman Underwood's effort to build on that legislation.

I was honored that, in her first few months in office, Congresswoman Underwood joined me on two separate trips to the southern border. She drafted this bill as a direct result of what she witnessed on those trips.

H.R. 3525 directs DHS to consult with medical experts to improve its medical screening process and to finally establish an electronic health record system for people in CBP custody.

DHS has always been on the cutting edge of innovation, leveraging the latest in technological advances to fulfill its critical mission of protecting our homeland. And I believe it is now vital that DHS use that same approach when caring for the individuals and families in its custody.

The Department has a long, successful history of working with the private sector to achieve its counterterrorism, emergency response, and cybersecurity goals.

This bill would require DHS to consult with national and medical professional associations who have the expertise in emergency medicine, nursing, pediatric care, and other relevant medical skills to make sure that DHS is providing appropriate medical care to migrants in its custody.

It specifically instructs DHS to research innovative approaches for screening vulnerable populations, including pregnant women, the elderly, and people with disabilities.

CBP is long overdue for an electronic health records system. In 2019, there is no good reason why an agency under as much strain as CBP is still using paper records. An electronic health record system would improve CBP's internal operations and expedite coordination when children and adults are transferred to other agencies.

I would hope that my colleagues on the other side of the aisle agree that not one more child should die in the custody of the Federal Government.

This bill should not be controversial. It is bipartisan; it offers commonsense solutions; and it will help save lives.

I strongly urge my colleagues to join me in supporting H.R. 3525 today.

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Mr. THOMPSON of Mississippi. Jackson Lee).

(Ms. JACKSON LEE asked and was given permission to revise and extend her remarks.)

Ms. JACKSON LEE. Mr. Speaker, thank you very much for the leadership of the chairman, and I appreciate the ranking member on the floor.

I have had the privilege of traveling with Congresswoman Underwood to the border in some very challenging circumstances, and I appreciated, as a nurse, as a trained nurse, as she is a trained nurse, I appreciated the astuteness with which she viewed this matter.

Let me say to my good friend, the doctor, we are always looking forward to trying to work with our colleagues on the basic humanity of every person, recognizing that this is not about healthcare for undocumented immigrants. It is about individuals who are in the custody of the United States.

Just picture for a moment, having gone to the border now for almost two decades as a resident of Texas, just imagine that there are moments when there is an influx of individuals fleeing for their lives. It happened under President Obama's administration in 2014, and we managed it. There was no hysteria. There were facilities that were built. There was medical care that we were able to access.

In this instance, it did not happen. And the glaring reality of children who died and those who were working hard, the law enforcement personnel, I saw them trying to do as much as they could, but without a structure, we lost lives. So the importance of this legislation is particularly one that I think is important.

Picture for a moment, when we were in the midst of the crisis, Coast Guard medical personnel, doctors with a table, some medicine on the corner, their medical paraphernalia out in the open where files were, no place to deal with the medical needs of anyone. That is not American.

We are not asking to provide healthcare. This is not Medicare or Medicaid. It is a basic dignity of protecting the American people by ensuring that these people are treated for whatever might be necessary.

So the e-record process is powerful because it allows the accessing of medical care by having a record system and also by having that system being accessed by all DHS components operating on the border. It is just a simple case of protecting those of us in the United States, protecting those who are in our custody.

Why not? Why not be proactive and positive for dealing with fellow human beings?

Let's get away from this undocumented and realize this is a land of laws and immigrants. We all, collectively, together, want to abide by that.

But we also realize that, when 9-month-old Roger is in my hands, and he crossed the border in the arms of his sister, that 9-month-old Roger, even though I saw him in one of the HHS centers, probably needed care.

Or the woman who had given birth 45 days earlier and holding in her hands a 45-day-old baby who had not seen a doctor, she had not been to the hospital. This might help give aid to those individuals.

So let me be very clear: This is an important initiative. It is an initiative that I think most Americans will support.

I rise to support the gentlewoman's legislation and thank her for her courage and astuteness in bringing this to our attention.

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Mr. THOMPSON of Mississippi. Mr. Speaker, how much time do I have remaining?

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Mr. THOMPSON of Mississippi. Barragan).

Mrs. WATSON COLEMAN. Mr. Speaker, I want to thank the chairman for yielding, and I want to thank my colleague, Ms. Underwood, for her work on this very important issue.

For nearly a year now, we have watched with growing horror and outrage as the cruel and inhumane combination of xenophobia, malicious policy from the White House, and indifference to people in need has built into a crisis at our southern border.

We have let this come to a point where children have died, children fleeing violence and persecution and horrors in their home countries seeking to come here, the land of opportunity and promise, children we separated from their parents and loved ones, children that we failed entirely here on our soil and in our custody.

We cannot allow that to continue, and this measure that we are taking up today will take important steps to address gaps in medical screening at the border so that we don't fail any more children. It pushes us to find new ways to handle the unique needs of health screening at the border, with special emphasis on children and vulnerable groups.

Just as importantly, it mandates implementation of an e-record system so that we are not letting anyone slip through the cracks.

An e-record system is not something we have never heard of before. What has happened at the border thus far, including the tragic deaths of the children, those mentioned by my colleague like Jakelin Caal Maquin and Felipe Gomez Alonzo, is proof that we are not doing enough, and that is not because we can't.

I am grateful to Ms. Underwood for stepping up to ensure we do more, and I urge all of my colleagues to support this important bill and its passage.

Mr. Speaker, in the last year, six children have died after being in CBP custody. This disheartening statistic demands our attention, especially when you stop to think that, in the entire decade preceding these deaths, not one child died in CBP custody.

Processes for the treatment of migrants crossing the border clearly need to be improved. H.R. 3525 does that by forcing DHS to look at its medical screening process and come up with ways to improve it and address any performance gaps. It also helps move the Department's recordkeeping into the 21st century.

H.R. 3525 is one step we can take to ensure that the money that DHS is already spending on screening and caring for apprehended families and children is done wisely.

And I might add, Mr. Speaker, all of us saw the conditions that children were kept in along the border. You can't put children in fences. You can't give people inadequate healthcare. You can't do those things.

Most of us in this body are either parents or grandparents or we have relatives who are. For us not to care about children is something that America should never be proud of. We are a nation of values. Our values have to say that children matter.

Ms. Underwood's bill clearly says that children in the custody of the United States Government matter. Not only do they matter, but we have to keep up with them; we should not lose them. If they are sick, we need to have copies of their records accessible so that our professionals who are tasked with the responsibility of taking care of them actually know what is going on.

So I am clear about the bill. If my colleagues on the other side are not interested in helping children and solving this problem that we have along our borders, then that is too bad. Democrats are prepared to work with them if they want to. If not, children do matter.

Mr. Speaker, I urge my colleagues to support H.R. 3525, and I yield back the balance of my time.

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