U.S. Border Patrol Medical Screening Standards Act

Floor Speech

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Ms. UNDERWOOD. Mr. Speaker, I introduced the U.S. Border Patrol Medical Screening Standards Act in response to the conditions I witnessed firsthand on our border this year: first in April, then in July, and then again in August.

The humanitarian crisis at our border is a problem that we should be working together to solve with an evidence-based approach. This legislation is evidence-based, and I am incredibly proud that it was able to be forwarded by the Committee on Homeland Security with a voice vote.

I also appreciated Ranking Member Rogers' willingness to engage with us on this bill, and I am committed to continuing to look for ways to work together on these issues going forward.

As introduced, my bill had three sections, two of which are included in the legislation we are debating today.

First, my bill ensures implementation of an integrated electronic health records system, or EHR, to be used by those caring for migrants at the border. This is a direct ask from medical officers at the Department of Homeland Security who have identified it as a high- priority barrier to providing care.

We know that migrants may be transferred between different sites and components multiple times while in custody, and an interoperable EHR is essential to their health records remaining accessible.

Immigration and Customs Enforcement has an EHR. The Office of Refugee Resettlement has an EHR. But Customs and Border Protection, which includes the U.S. Border Patrol, doesn't.

When I was at the border, I saw busy, overworked Border Patrol officials having to keep health records on paper. I also saw how these records don't always follow migrants between facilities and transfers of custody.

As DHS works to improve its medical screening of children and migrants at the border to ensure there is a minimum standard of care, the need for proper recordkeeping on those screenings will only increase.

Furthermore, children can spend days or weeks in CBP custody before being transferred to another component. There must be a transferrable record of the medical care those kids receive and the medical conditions that they report. That is why DHS has already begun independently taking steps toward an electronic health records system, hiring staff, and soliciting individual component requirements.

This legislation formalizes and directs that process, setting an aggressive but achievable timeline that reflects the urgency of the humanitarian situation at our southern border.

Second, this bill directs DHS to research innovative approaches to address any capability gaps in providing medical screening, particularly for children, pregnant women, the elderly, and other vulnerable populations.

As a nurse, I believe in data-driven, evidence-based policymaking. Data shows that, in recent years, the migrant population arriving at our southern border has shifted from primarily adult, economic migrants to a large number of families and unaccompanied children seeking asylum.

DHS must be better prepared to respond to these shifts, and barriers to providing basic medical care to migrants in U.S. custody will persist as our country continues its national conversation around immigration policy. The research required by this litigation will ensure that we have robust data on DHS' capabilities in order to inform our response.

My bill also ensures that, in conducting this research, DHS collaborates with medical professionals who have expertise in pediatric care so that DHS is addressing both the physical and the mental health needs of migrant children at the border. By proactively focusing on children, this research is intended to prevent the care gaps we have seen in other Federal facilities caring for migrant children.

Lastly, I am proud that the third section of this bill, as introduced, was incorporated into my colleague Dr. Ruiz' legislation that was passed by the House in July. This section set consistent minimum standards for medical screening of migrants at the border.

Proactive, consistent, and timely medical screening is essential to a public health response to the humanitarian crisis on our border, but effective medical protocols are not in practice right now.

By training border personnel in medical screening, the legislation provides law enforcement and staff at the border the support that they need so that they aren't being forced to deal with medical situations that we haven't equipped them for. That is why I am pleased that this screening language passed the House in July.

In addition to these medical screening standards, we need to ensure DHS has an electronic health record and close those research gaps. That is what this legislation on the floor right now would do: build on the legislation we passed in July and implement the remaining two components of the U.S. Border Patrol Medical Screening Standards Act.

Anyone who has been to the border, including many of my colleagues on the Committee on Homeland Security, has seen how overwhelming the humanitarian situation there is. This committee and this Congress have consistently been willing to provide the Department of Homeland Security with the resources it needs, but with those resources comes accountability and oversight. This legislation is an important and a sensible step forward to make sure that both migrants and border officials are not placed in situations that are unsafe.

Mr. Speaker, in closing, I want to recognize and thank Chairman Thompson and his staff on the Committee on Homeland Security--including Rosaline Cohen, Alexandra Carnes, Wendy Clerinx, Ethan McClelland, and Brittany Lynch--for their months of hard work on this legislation, and I urge my colleagues on both sides of the aisle to support it.

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